title: PROGNOSTIC INDICATORS OF VISUAL ACUITY AFTER OPEN GLOBE INJURY AND RETINAL DETACHMENT REPAIR.
abstract: OBJECTIVE
  To identify prognostic indicators of postoperative visual acuity and retinal detachment (RD) in open globe injuries.
  
  
  METHODS
  Retrospective review of 50 adult open globe injuries between September 2011 and March 2014. Hierarchical multivariable regression was used to evaluate relationships among injury characteristics, postoperative visual acuity, and RD after age adjustment.
  
  
  RESULTS
  Mean participant age was 46.2 years, and mean follow-up was 1.2 years. Blunt trauma accounted for 58% of injuries (29/50), and the wound extended posteriorly into sclera in 64% of cases (32/50). The retinal detachment occurred in 40% of patients (20/50), 95% of whom had developed vitreous hemorrhage (19/20). Multivariable regression revealed that preoperative visual acuity (P = 0.0010), posterior wound extension (P = 0.022), and RD (P = 0.0038) independently predicted postoperative visual acuity. No other injury characteristic was related to postoperative visual acuity after adjustment for preoperative visual acuity. Vitreous hemorrhage predicted RD (P < 0.001), and further consideration of preoperative visual acuity and other variables did not improve model fit. Moreover, among patients who underwent RD repair (n = 13), earlier vitrectomy after vitreous hemorrhage diagnosis (≤12 days) was associated with fewer macula-off RDs (P = 0.018) and better postoperative visual acuity (P = 0.0055).
  
  
  CONCLUSIONS
  Preoperative visual acuity, posterior wound extension, and RD significantly influenced postoperative visual acuity after open globe injury. Vitreous hemorrhage predicted RD, and prompt intervention after detection may improve visual outcomes.
authors.affiliation: Department of Ophthalmology, Ross Eye Institute, University at Buffalo, The State University of New York, Buffalo, New York.
authors.forename: Henry
authors.initials: H
authors.lastname: Lin
authors.forename: Gareth M C
authors.initials: GM
authors.lastname: Lema
authors.forename: Pradeepa
authors.initials: P
authors.lastname: Yoganathan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017679:Cryotherapy; D058450:Endotamponade; D015807:Eye Injuries, Penetrating / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012163:Retinal Detachment / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012590:Sclera / Q000293:injuries; D012827:Silicone Oils / Q000008:administration & dosage; D015599:Trauma Severity Indices; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy; D014823:Vitreous Hemorrhage / Q000175:diagnosis; D014949:Wounds, Nonpenetrating / Q000175:diagnosis
chemical_list: D005466:Fluorocarbons; D012827:Silicone Oils; C042852:perflutren