Abstract
ABSTRACT: PURPOSE: To evaluate the baseline characteristics, intraoperative choices and outcomes of the surgical management of open globe injuries. ABSTRACT: SETTING: Longitudinal, monocentric, retrospective study, conducted at the University Hospitals of Geneva. ABSTRACT: METHODS: All cases of adults were included with an open globe injury, with or without an intraocular foreign body (IOFB), at a tertiary university centre and for the period between January 2013 and July 2023. The primary outcome was the eye status at the final follow-up visit (defined as the anatomical final outcome). Secondary outcomes included the final best-corrected visual acuity (BCVA), the number of surgical interventions required to stabilise the eyes and the adverse events (AEs). ABSTRACT: RESULTS: 37 eyes of 37 patients were included. The main type of penetrating injury was through a scleral wound (51.4%; n = 19), and the main cause of injury was occupational (46.0%; n = 17. Nine patients (n = 24.3%) presented an IOFB, 88.9% (n = 8) into the vitreous cavity and 11.1% (n = 1) into the anterior segment. Primary wound closure alone was performed in 81.1% of cases, while combined wound closure and pars plana vitrectomy was performed in 18.9%. Primary globe closure was successful in 91.9% of eyes. 21 eyes (56.8%) required a subsequent PPV after the first surgery (with success rate of 81.0%). Removal of most of IOFBs was performed during the first surgical intervention (66.7% vs. 33.3% during the second). Mean BCVA improved significantly during the follow-up (0.08 ± 0.20 decimals at baseline vs. 0.3 ± 0.41 decimals at the final follow-up; p < 0.05). The most frequent AE was rhegmatogenous RD, that was found in 54.1% (n = 20) of eyes at any time during the follow-up. One eye presented with exogenous endophthalmitis secondary to the open globe injury. Average follow-up time was 28.6 ± 32.8 months (range 12 - 96 months). ABSTRACT: CONCLUSIONS: In order to preserve the anatomical outcome, globe closure should be performed rapidly. Retinal detachment seems to be the most common complication and may occur months after the trauma. Good anatomical and functional results can be achieved, with appropriate surgical management, even in challenging cases.