Characteristics of Open-globe Eye Injuries with Respect to Zone of Injury.
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Date
2014-07-11
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Abstract
Aims: To describe the demographics, characteristics and outcomes of open-globe
injuries (OGI) with respect to zone of injury.
Methods: Medical records of all patients presenting with OGIs to University Hospital,
Newark, NJ between January 2001 and December 2008 with a follow-up of at least 3
months were reviewed. Demographics, characteristics of the trauma and outcomes were
compared with respect to the zone of injury; location of injury is confined to the cornea
and limbus in zone 1 (Z1), <5 mm posterior to the limbus in zone 2 (Z2) and >5mm
posterior to the limbus in zone 3 (Z3).
Results: Of the 309 patients (310 eyes) identified, 228 (74%) were male. The mean age
at presentation was 35.3 years (1-96). Mean follow-up was 22.8 months (3-108 months).
Most of the eyes presented with Z1 injury: 141 eyes (46%) Z1 injury, 83 (27%) Z2 and 86
(28%) Z3. Rupture was the most common type of injury in Z2 and Z3 injuries. Nineteen
(86%) of 22 eyes with an intraocular foreign body (IOFB) had a Z1 injury. 32 (42%) of 77
eyes with Z3 injury had no light perception (NLP) at presentation, compared with 9 (8%)
of 119 Z1 and 13 (17%) of 78 Z2-injured eyes. Four percent of Z1, 11% of Z2 and 18% of
Z3-injured eyes had a final vision (VA) of NLP. Primary enucleation was undertaken in 10 eyes (9 were Z2 injured eyes). Secondary enucleation was performed in 12 (9%) of 141
Z1, 7 of 82 (9%) of Z2 and 22 (26%) of 78 Z3 eyes. Thirty (36%) of 86 Z3 injuries resulted
in primary or secondary enucleation. The final Snellen VA was 1.05, 1.41, and 2.19
respectively in Z1, Z2 and Z3-injured eyes. Posterior segment surgery was performed in
30% Z1, 39% Z2 and 49% Z3-injured eyes. Retinal detachment (RD) was diagnosed in
11% Z1, 27% Z2 and 40% Z3 injuries.
Conclusion: Z1 injury may be associated with a better visual prognosis than Z2 and Z3
injuries. The visual prognosis of Z3 injured eyes is poor with one-third of these eyes being
enucleated.
Description
Keywords
Ocular trauma, zone of injury, open globe, prognosis, ruptured globe
Citation
Tu Yufei, Soni Nishant G, Bauza Alain M, Zarbin Marco A, Bhagat Neelakshi. Characteristics of Open-globe Eye Injuries with Respect to Zone of Injury. British Journal of Medicine and Medical Research. 2014 July; 4(20): 3767-3776.