Original articleEnucleation for Open Globe Injury
Section snippets
Methods
The electronic and paper medical records of all patients with a diagnosis of open globe injury presenting to the Massachusetts Eye and Ear Infirmary between January 1, 2000 and June 30, 2007 were reviewed. Patients were identified in the hospital database by searching for patients with open globe codes and from the surgical logs of the trauma surgeons. Patients who underwent open globe repair at a separate institution were excluded. Variables assessed included age, gender, type of injury
Results
During the study period 660 open globe injuries were evaluated and 55 (8.3%) have undergone enucleation (including 4 eviscerations). Patients with open globe injuries requiring enucleation did not differ significantly from those not enucleated with respect to age and gender (Table 1).
Data on the OTS classification and injury type are presented in Table 2. An OTS could be calculated on 607 patients (92%). Patients with ruptures were significantly more likely to undergo enucleation than those
Discussion
Our data show that most patients with open globe injuries can be successfully surgically repaired, with only 11 of 660 (1.7%) requiring primary enucleation. The most common indication for secondary enucleation in this series was a blind, painful eye. Ruptures were significantly more likely to require enucleation than lacerations. Although sympathetic ophthalmia is a well-known risk, it was seen infrequently (0.3%) and responded well to treatment. A large proportion of the NLP eyes following
Aaron Savar, MD, is currently a fellow in ophthalmic plastic and reconstructive surgery at the University of Texas MD Anderson Cancer Center in Houston, Texas. He received his medical degree from Boston University School of Medicine and completed his ophthalmology residency at the Massachusetts Eye and Ear Infirmary in Boston, Massachusetts. His clinical interests include periocular malignancies, reconstructive surgery, and ocular trauma.
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Aaron Savar, MD, is currently a fellow in ophthalmic plastic and reconstructive surgery at the University of Texas MD Anderson Cancer Center in Houston, Texas. He received his medical degree from Boston University School of Medicine and completed his ophthalmology residency at the Massachusetts Eye and Ear Infirmary in Boston, Massachusetts. His clinical interests include periocular malignancies, reconstructive surgery, and ocular trauma.