Abstract
Background/Objectives
To evaluate the factors influencing final visual outcome after surgical repair of open globe injuries (OGIs) in a rural population using the International Globe and Adnexal Trauma Epidemiology Study (IGATES) online registry.
Subjects/Methods
Retrospective cohort study of patients with OGI. OGIs were identified from the IGATES database at a tertiary referral eye care centre in rural West India over a period of 12 years. Patient demographics, clinical and pre-operative factors affecting final visual outcome was evaluated.
Results
A total of 791 eyes with OGIs were included in data analysis. 11 eyes that were lost to follow-up and 12 eyes with incomplete data were excluded. Most of the patients were male (559, 70.6%) and mean age of all patients was 23.9 years ± 19.4 years. Occupational hazards (including domestic housework) (307, 38.8%) and leisure play (324, 41.0%) were the leading causes of OGI. The most common mechanism of injury was being struck by a wooden stick (250, 31.6%).
Univariate analysis of pre-operative variables showed initial visual acuity (VA), zone of injury, size of wound, structures involved in the injury and presence of infection were significant prognostic factors for worse final visual outcome (p < 0.001). Multivariate analysis showed VA ≤ 3/60 or worse at presentation had statistically significantly higher odds ratio of ending up with worse visual outcomes (p < 0.012).
Conclusions
Males in working age groups suffer from OGIs more frequently, usually from agricultural and pastoral activities. Initial VA, zone 3 injuries, corneoscleral wound, large wound size and presence of post-traumatic infections are significant prognostic factors.
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There is no funding involved in this study. AKH is supported by a National Health and Medical Research Council Dora Lush Postgraduate Research Scholarship and is an employee of Essilor. No other authors have no financial disclosures.
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ZHT was responsible for and contributed towards material preparation, data extraction and analysis, interpreting results, drafting of the initial manuscript and subsequent edits and updating of reference list. SMS and MS were responsible for the study conception, design as well as data collection and extraction. CHC contributed towards data extraction and analysis, creating the tables under the results section and provided feedback on the manuscript. RA and AKH provided guidance throughout data analysis, results interpretation and feedback on the manuscript. All authors have read and approved the final manuscript.
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Toh, Z.H., Shah, S.M., Chua, C.H. et al. International Globe and Adnexal Trauma Epidemiology Study (IGATES): Visual outcomes in open globe injuries in rural West India. Eye 37, 88–96 (2023). https://doi.org/10.1038/s41433-021-01895-2
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DOI: https://doi.org/10.1038/s41433-021-01895-2
