DOI: 10.4103/ojo.ojo_316_23 ISSN: 0974-620X

Characteristics, outcomes and prognostic factors after primary repair of corneal or corneoscleral lacerations in open globe injury: A multicentric study from North India

Nidhi Gupta, Sharad Nivrutti Gomase, Samrat Chatterjee, Gautam Singh Parmar, Ashi Khurana, Garima Chaudhary, Karan Bhatia, Purvasha Narang, Ashok Kumar Meena, Sanjay Chanda, Virender Singh Sangwan

Abstract:

PURPOSE:

To report the clinical characteristics, visual and ocular survival, and prognostic factors in eyes undergoing primary repair for corneal or corneoscleral lacerations in open globe injuries.

METHODS:

This multi-centric retrospective case series from north India included patients who had undergone primary corneal or corneoscleral tear repair with a minimum follow-up duration of 6 months.

RESULTS:

Of the 444 patients, 361 (81.2%) were males. The mean age of the patients was 21.5 ± 16.0 years. The commonest mode of injury was with metal objects (31.3%). The mean pre-operative best corrected visual acuity improved from 1.97 ± 0.76 log MAR units to 1.37 ± 0.89 at the postoperative 3-month visit ( P < 0.0001) and 1.08 ± 0.96 at the postoperative 6-month visit ( P < 0.0001). The integrity of globe was maintained in 88.3%patients, while 8.8% patients developed phthisis bulbi at six month follow up, and 13 patients underwent either evisceration or enucleation. Poor visual outcomes were associated with age ( P = 0.046), use of steroids prior to presentation ( P = 0.001), corneal laceration involving visual axis ( P = 0.009), endophthalmitis ( P = 0.023), retinal detachment ( P = 0.007), and poor preoperative visual acuity ( P < 0.001). Poor ocular survival was associated with female sex ( P = 0.003), time interval between injury and presentation ( P = 0.033), preoperative visual acuity ( P = 0.002), corneal infiltrate ( P = 0.021), prolapse of uveal issue ( P = 0.021), endophthalmitis ( P < 0.001), and retinal detachment ( P < 0.001).

CONCLUSION:

Although significant improvement in visual acuity and maintaining ocular integrity was achieved following corneal tear repair, addressing the identified risk factors can improve overall outcome.

More from our Archive