Two kinds of ocular trauma score for paediatric traumatic cataract in penetrating eye injuries

Clinical evaluation and management of badminton-related eye injuries: a retrospective case series

BACKGROUND

To describe the clinical features, visual outcomes, management, and complications of ocular injury in badminton and investigate risk factors associated with visual impairment.

METHODS

Data on patients injured while playing badminton admitted to Department of Ophthalmology, Eye, Ear, Nose, and Throat Hospital, Fudan University between January 2018 to December 2020.The relationship between visual acuity (VA) and demographic and clinical variables was also analyzed. Patients were managed medically or surgically as per their needs, followed up for at least 18 months. The visual outcomes were predicted using ocular trauma score (OTS), predicted outcomes were compared with actual outcomes using statistical tests.

RESULTS

This study involved 102 patients (78 men, 24 women) with a mean age of 43.8 ± 16.1 years (7-71 years). Of these, 93 patients had closed-globe injuries and 9 had open-globe injuries. Vision-threatening findings included lens subluxation(31.4%),retinal detachment(13.7%),hyphema(12.7%). Open-globe injury had significantly lower presenting VA and final VA (P= 0.0164, 0.0053).Final VA was found to be correlated with presenting VA, maculopathy, retinal detachment, and OTS (P=0.0000, 0.0494, 0.0001, 0.0000 respectively), it was worse in patients who were under 20 years of age and were female. OTS prediction was not significantly different when compared with actual visual outcomes postoperatively in OTS3, OTS4, and OTS5 (P > 0.05),while the prognosis of patients with OTS1 and OTS2 was better than OTS study (P=0.001, 0.007, respectively).

CONCLUSION

Badminton-related closed-globe injuries were more frequent; open-globe injuries were usually more serious. Younger and female patients have poorer visual recovery prognoses. OTS was found to be a reliable tool for predicting visual outcomes.

Pediatrik Hastalarda Oküler Travmaların Etiyolojik Özellikleri ve Görsel Sonuçları

Amaç: Açık glob yaralanması (AGY) nedeni ile acil kliniğimize başvuran, tedavi ve takibi yapılan 60 pediatrik olgunun demografik özelliklerini ve prognozu etkileyen faktörleri araştırmak. Yöntem: Kliniğimizde 2010-2021 yılları arasında AGY nedeni ile ameliyat edilip, en az bir yıl takip yapılmış olan 16 yaş ve altı 69 olgunun dosya kayıtları retrospektif olarak incelendi. Kayıtlardan AGY’nin tipi, oluş nedeni, eşlik eden muayene bulguları, hastaneye başvuru zamanı ile ilk ve son görme keskinlikleri (GK), ek cerrahileri kaydedildi. Bulgular: Olguların ortalama yaşı 11±5 yıl idi. %17,4’si kız %82,6’sı erkek idi. AGY’nin şekli en sık korneal kesi, en sık etiyolojik nedeni kesici ve delici aletler (%65,1) oluşturmakta idi. Olguların %87 sinde sadece bölge 1, %40,6 sında bölge 2, %13 ünde bölge 3 etkilenmişti. Olguların %37,7 sinde relatif afferent pupil defekti (RAPD) vardı. %5,8’i rüptür, %8,7’si retina dekolmanı, %2,9’u endoftalmi, %4,3’ü perforan yaralanma idi. Olguların başvuru anında %7’sinde GK değerlendirilemezken, %60’ında 0.1 ve daha altında, %25,7’sinde 0.1-0,6. %4,3’ünde ise 0.6’dan daha iyi GK’ya sahipti. Olguların takiplerinde 6. ayda ise %2,9’ unda GK değerlendirilemezken (inop), %11,4’ ünde 0.1 ve daha altında, %25,7’sinde 0.1-0.6 ve %60’ında ise 0.6’dan daha iyi GK’ya sahipti. Oküler travma skoru (OTS) 74±16, pediatrik oküler travma skoru (POTS) 64±19 idi. OTS başlangıçtaki GK ile orta derecede ilişkili (r=0,687, p<0,001), takipteki GK ile orta derecede ilişkili (r=0,611, p<0,001) idi. Pediatrik oküler travma skorunun korelasyon değerleri ise daha düşük bulundu (başlangıç GK ile r=0,574, p<0,001). Sonuç: Pediatrik AGY’de görsel prognozu tahmin edebilmek için RAPD değerlendirilemediğinde bile OTS güvenilir bir araçtır.

New model for the prediction of visual outcomes in young children with mechanical ocular conditions and comparison with other models

Purpose

Herein, we compared the efficacy among the Ocular Trauma Score (OTS), Toddlers Ocular Trauma Score (TOTS), and Pediatric Ocular Trauma Score (POTS) for prognosis prediction in Indian children who had mechanical ocular conditions causing traumatic cataract.

Methods

This prospective, interventional study recruited consecutive children undergoing operation for traumatic cataracts caused by mechanical eye injuries at Drashti Netralaya. The following details were obtained from their medical files: the circumstance and time of injuries, penetrating injury type, initial and final visual acuity (VA), time of operation, and associated eye diseases. Specific variables were employed to determine the OTS, TOTS, and POTS. For all patients, the final and predicted VA determined using all scores were compared using Fischer's exact test. Accuracy, specificity, and sensitivity were evaluated for all the scores by using the area under receiver operating characteristic curve.

Results

We enrolled 124 eyes. Patients' mean value for age was 4.6 ± 1.29 years; 44 (35.41%) and 74 (64.5%) were female and male patients, respectively. Visual outcomes significantly improved after operation, and the outcomes did not differ between closed- and open-globe injuries (P = 0.162). The actual and predicted VA did not exhibit a statistically significant difference among the three scores. TOTS and POTS were more suitable for evaluating low-risk injuries, whereas the OTS could more efficiently examine high-risk cases.

Conclusion

TOTS and POTS were more accurate than the OTS in VA prediction after operation in toddlers with traumatic cataracts caused by mechanical globe injury. TOTS and POTS were more suitable for evaluating low-risk injuries, whereas the OTS could more efficiently examine high-risk cases. All the examined scores can be helpful in estimating VA following treatment.

Pediatric traumatic cataracts: 10-year experience of a tertiary referral center

Background

This study aimed to evaluate the factors influencing final visual acuity in pediatric traumatic cataracts.

Methods

Data of patients who presented with traumatic cataracts were reviewed retrospectively. We evaluated age at trauma; gender, trauma type, cause, and zone; duration between the time of trauma and cataract surgery; surgical method used; time, location, and type of intraocular lens (IOL) implantation; initial and final best corrected visual acuity (BCVA); amblyopia rate; and complications.

Results

In all, 61 eyes of 59 patients aged < 16 years with cataracts after trauma were included. The mean age of the children was 7.2 ± 3.9 years. Primary IOL implantation was performed in 70.9% of eyes. The BCVA was 0.7 LogMAR or better in 5.9% of the 49 eyes in which the visual acuity could be measured at the time of trauma and in 69.1% of 55 eyes in which it could be measured after treatment. Evaluation of factors potentially influencing the final visual acuity revealed that eyes that had undergone posterior capsulotomy (PC) and anterior vitrectomy (AV) during cataract surgery had significantly better final visual acuity compared with eyes that did not undergo these procedures.

Conclusions

In children with posttraumatic cataracts, final visual acuity was not affected by patient age and gender; trauma type, cause, and zone; duration between the time of trauma and cataract surgery; surgical method used; and time, location, and type of intraocular lens (IOL) implantation. Improvements in the final BCVA could be seen only by PC + AV combined with lens aspiration with or without IOL implantation. However, this approach of amblyopia treatment needs to be confirmed by more comprehensive and prospective studies.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12886-022-02427-6.

Epidemiological findings of childhood ocular trauma in a public hospital in Colombia

Background

Eye injury is a serious worldwide public health problem that may cause blindness. In children, blindness has functional impact and psychosocial implications. As indicated in many worldwide studies, identification of risk factors associated with the socio-cultural context may prevent eye injuries. The objetive of the study is to describe the sociodemographic and epidemiological characteristics of pediatric eye injury and its effects on ocular structures in a public hospital from Colombia.

Method

A retrospective cross-sectional study was carried out between January 1, 2015, and December 31, 2017, in a tertiary public hospital of a medium-sized city located in the Northeast of Colombia. Children under 15 years old with trauma to the eyeball or its adnexa were included. The Birmingham Eye Trauma Terminology System (BETTS) was used. Eye burns and Ocular adnexa were also included.

Results

61 cases of eye injuries were recorded, 67.21% (41 cases) of which were males. 57.37% (35 cases) corresponded to closed-globe injuries both contusion and lamellar laceration. Visual acuity fluctuated between 20/20 and 20/40. 14.75% (9 cases) were open-globe injuries while 50% (4 cases) were penetrating trauma. 27.86% of the injuries (17 cases) did not directly compromise the eyeball, 58.82% (10 of these cases) of which corresponded to eyelid wounds, and neither of those had visual acuity information.

Conclusion

The study showed that the majority of eye injuries in children under 15 years old, from a public hospital in the Northeast of Colombia, are closed globe, caused by blows, and occur in males.

Pediatric open globe injury in left-behind children treated by pars plana vitrectomy in China

BACKGROUND

To analyze the clinical features of pediatric open globe injury (OGI) in left-behind children (LBC) and in non-left-behind children (non-LBC) prospectively.

METHODS

Patients diagnosed with OGI were included and divided into 2 groups: LBC and non-LBC. A complete ophthalmological examination was performed. Primary wound repair was completed within 8 hours from initial administration. Pars plana vitrectomy (PPV) was subsequently performed for retained intraocular foreign body (IOFB), endophthalmitis, retinal detachment, or non-clearing vitreous hemorrhage.

RESULTS

A total of 96 patients (4 to 15 years old) were recruited, including 54 LBC and 42 non-LBC. Rupture of the eyeball (P<0.001), endophthalmitis (P<0.001), primary hospitalization time (PHT) over 24 hours (PHT >24 h) (P=0.016), traumatic cataract (P=0.013), vitreous hemorrhage (P=0.040), numbers of surgeries (P<0.001), and lower OTS scores and grades (P<0.001) predisposed patients to poorer final visual acuity (VA). Compared with non-LBC, LBC were significantly younger (P<0.001), had lower OTS scores (P=0.020), had longer PHT (P<0.001), and worse baseline (P=0.011) and final VA (P<0.001). The 3 most common injury sources were pencils (20 cases, 20.8%), knives (11 cases, 11.5%), and iron wire (7 cases, 7.3%). Pencils were the major injury source for IOFB (14 cases, 53.8%). LBC were significantly more likely to be injured by instruments which should be routinely kept away from children (P=0.009).

CONCLUSIONS

The prognosis of pediatric OGI was worse in LBC than in non-LBC. It is necessary to improve the guardianship of LBC. Many tragedies may be avoided if adult instruments are properly stored and if children are educated to properly use writing devices.

Comparison of the Ocular Trauma Score and Pediatric Ocular Trauma Score as Two Prognostic Models in Pediatric Open Globe Injuries

AIM

To compare the ocular trauma score (OTS) and the pediatric ocular trauma score (POTS) as prognostic models of visual outcome after open globe injury in children during a period of 19 years.

PATIENTS AND METHODS

A retrospective study of 36 open globe injuries in 36 patients younger than 18 years was conducted from January 2000 to January 2019. For each case, OTS and POTS points were calculated.

RESULTS

Significant differences were observed in our patients using the two models regarding categories 1 to 4. One third of the cases were in categories 1 and 2 using the OTS model, and nearly 60% using the POTS model. Nearly 60% of our patients were in categories 3 and 4 using the OTS model and 30.6% using the POTS model. In category 5, no difference was observed between the two models. The comparison of distribution of the percentage of final visual acuity between OTS and POTS model in each category revealed a significant difference in category 1 in final visual acuity 20/40 or more (25 vs. 50%) as well as in final visual acuity 20/20 (0 vs. 30%). In category 2, final visual acuity was not significantly different in 20/40 or more between the two models; however, there was a significant difference in final visual acuity 20/20 - 12.5% in the OTS model and 45.5% in the POTS model. In category 3, significant differences were revealed between the two models. Using the OTS model, final visual acuity 20/40 or more was observed in more than 60% and using POTS model in 100%; final visual acuity 20/20 was observed in 36.3% using OTS model and in 50% using POTS model. In category 4 and 5, no differences were observed between OTS and POTS models.

CONCLUSION

Our study did not confirm the benefit of POTS. The distribution of our cases among OTS categories demonstrated a significant difference between the two models with more cases distributed in lower categories in POTS group. In the POTS group, the prognosis for final visual acuity was significantly better in the first three categories than in the OTS group, probably as a result of a lower calculation for POTS points. In our opinion, the OTS model is easier to use, has a higher prognostic accuracy, and should be further used in counselling of paediatric cases.

Application of pediatric ocular trauma score in pediatric open globe injuries

AIM

To evaluate the predictive value of pediatric penetrating ocular trauma score (POTS) on the visual outcome in children with open globe injury.

METHODS

A retrospective study in 90 children (60 males and 30 females) aged 1-15y (average, 7.48±2.86y) with penetrating ocular trauma was performed. Each patient's POTS was calculated. The effects of POTS on final visual acuity (FVA) were examined. Correlation between factors affecting POTS and the FVA was established.

RESULTS

All patients presented with single-eye trauma. The follow-up time was 3-21mo (average, 10.23±3.54mo). Among the 90 cases of penetrating wounds, 71 eyes (78.89%) were injured in Zone I (wound involvement limited to the cornea, including the corneoscleral limbus), 17 eyes (18.89%) were injured in Zone II (wound involving the sclera and no more posterior than 5 mm from the corneoscleral limbus), and 2 eyes (2.22%) were injured in Zone III (wound involvement posterior to the anterior 5 mm of the sclera). Analysis of POTS and FVA showed important correlation between them (r=0.414, P=0.000). Initial visual acuity (P=0.00), age (P=0.02), injury location (P=0.002), traumatic cataract (P=0.00), vitreous hemorrhage (P=0.027), retinal detachment (P=0.003), and endophthalmitis (P=0.03) were found to be statistically significant factors for the FVA outcome.

CONCLUSION

Ocular trauma presents serious consequences and poor prognosis in children. The POTS may be a reliable prognostic tool in children with open globe injury.

Visual and ocular morbidity in severe open-globe injuries presenting to a regional eye centre in New Zealand

IMPORTANCE

Open-globe injuries (OGI) are a leading cause of monocular blindness world-wide with considerable cost to the individual and society.

BACKGROUND

To characterize the epidemiology, severity and outcomes of OGI treated at a major ophthalmology centre in New Zealand.

DESIGN

Retrospective study.

PARTICIPANTS

A total of 385 eyes of 381 patients over a 10-year period.

METHODS

Eligible patients were identified using diagnosis and surgery codes on hospital discharge summaries. Clinical notes were reviewed to determine patient demographics, injury details, treatments and outcomes.

MAIN OUTCOME MEASURES

Complications of injury, visual acuity at 3 months and final follow-up, and final status of the eye.

RESULTS

The estimated annual incidence of OGI was 2.8 per 100 000. Working-age males predominated but age at injury ranged from 9 months to 90 years. Maori and Pacific peoples were over-represented. Injuries were severe with 58.7% presenting with vision of hand movements or worse. Penetrating injuries (56.4%) were most common, followed by globe ruptures (35.6%). Major complications included retinal detachment (15.8%), enucleation/evisceration (9.1%), phthisis bulbi (9.9%), endophthalmitis (2.6%) and sympathetic ophthalmia (0.26%). Despite the injury severity, 46% of eyes achieved final BCVA of ≥6/12. The Ocular Trauma Score (OTS) was a useful prognostic tool for stratifying severity of injury and predicting visual outcome (Fisher's exact test P < 0.001).

CONCLUSIONS AND RELEVANCE

The incidence and severity of OGI in NZ are comparable to global statistics. Surgical repair can effectively recover vision, predicted well by the OTS. We identified at-risk groups to target with education and prevention strategies.

Pediatric Traumatic Retinal Detachment: Clinical Features, Prognostic Factors, and Surgical Outcomes

Purpose

We report the clinical characteristics, prognostic factors, and surgical outcomes for 23-gauge pars plana vitrectomy (23-G PPV) in pediatric cases of traumatic retinal detachment (RD).

Methods

Medical records of pediatric patients who underwent 23-G PPV to treat traumatic retinal detachment were retrospectively reviewed. These patients underwent a follow-up examination at least 1 year following surgery. Associations between various preoperative factors and anatomical and visual outcomes were analyzed. An Ocular Trauma Score (OTS) and a Pediatric Ocular Trauma Score (POTS) were calculated for each patient. Raw scores were converted to their corresponding OTS and POTS categories. Final visual acuities by categories were compared with those in the OTS and POTS studies.

Results

The mean age of the patients was 9 ± 4 years, and the male-to-female ratio was 4.7 : 1. The mean follow-up time was 23 ± 14 months. Anatomical success was achieved in 72% of the eyes, and functional success (>5/200) was achieved in 37% of the eyes. Functional success was less common among patients with visual acuities less than hand motion, macula-off retinal detachment, proliferative vitreoretinopathy at presentation, and recurrent retinal detachment during follow-up. When we compared the categorical distribution of final visual acuities in all categories, our results were significantly different than those suggested by OTS and POTS.

Conclusions

Visual outcomes are poorer compared to anatomical outcomes. OTS and POTS do not provide reliable prognostic information if the patient has RD. Presenting visual acuity, the presence of macula-off RD, and PVR are all important predictors of final visual acuity.

Epidemiology and clinical characteristics of patients hospitalized for ocular trauma in South-Central China

PURPOSE

Ocular trauma is a major cause of visual loss, but little is known about its epidemiology and clinical characteristics in China. The aim of this study was to determine the prevalence and clinical characteristics of ocular trauma and assess prognostic factors in Changsha, Hunan, located in South-Central China.

METHODS

A retrospective case series (ICD codes: S05) study of ocular trauma in patients was performed at the Second Xiangya Hospital, Central South University, from 1 January 2010 to 31 December 2014. Demographic information, injury causes, ocular trauma types and initial and final visual acuity (VA) were recorded and analysed. The ocular trauma score (OTS) was calculated to assess the extent of the eye injury, prognosis and factors associated with visual impairment. All patient data were collected from the medical records system.

RESULTS

Of the 2009 patients presenting during this 5-year period, 1695 (84.4%) were males and 314 (15.6%) were females. The average age of all patients was 37.0 ± 19.3 years (range from 1 to 87 years). The age distribution showed a peak in the ocular trauma population in the 41- to 50-year age group (24%, n = 482), followed by the 51- to 60-year age group (16.9%, n = 339). Overall, open-globe injuries had a higher frequency (70.7%, n = 1420) than closed-globe injuries (28.6%, n = 575) and thermal/chemical injuries (0.7%, n = 14). Of the open-globe injuries, corneal penetration was the most common injury (32.2%, n = 646) followed by rupture (21.5%, n = 432) and an intraocular foreign body (16.2%, n = 325). Overall, the most frequent ocular trauma setting was the workplace (39.6%, n = 795), followed by the home (28.4%, n = 570), and the most frequent activity was ironwork. Firecracker- and firework-associated ocular trauma was significantly higher during the months of January and February than during other months (50.0%, n = 112, p < 0.001). In patients under 18 years, the most frequently occurring injury was open globe (84.5%, n = 349) with corneal penetration (59.3%, n = 245). Overall, an operation was performed in 1865 (92.8%) cases, and 144 cases (7.2%) were treated conservatively with medication. The average OTS score was 47.1 ± 19.5. The visual prognosis was closely correlated with the initial VA (r = 0.570, p = 0.000) and the OTS score (r = 0.603, p = 0.000).

CONCLUSION

This study describes the epidemiology and clinical characteristics of patients hospitalized for ocular trauma in South-Central China. Notably, a high rate of firework-related ocular trauma occurred during the months adjacent to the Chinese New Year festival. Specific injury prevention strategies, such as the use of protective eyewear, need to target the workplace to reduce the incidence and severity of ocular trauma.

Efficacy and Safety of 23-Gauge Pars Plana Vitrectomy/Silicone Oil Tamponade Combination for Treatment of Pediatric Post-Traumatic Endophthalmitis

PURPOSE

To determine (i) the etiology, epidemiology, mechanism of injury, and risk factors associated with open globe injuries (OGIs) in children and (ii) visual outcomes of pediatric patients with post-traumatic endophthalmitis following 23-gauge pars plana vitrectomy (PPV) combined with silicone oil tamponade (SOT).

METHODS

A total of 107 consecutive patients, <15 years of age, who had been diagnosed with post-traumatic endophthalmitis between September 2009 and October 2015, were included in this 6-year retrospective study. All patients had undergone a combined PPV and SOT procedure. We reviewed records and analyzed several parameters, including age, gender, wound anatomy, intraocular foreign body characteristics, best-corrected visual acuity (BCVA), and anatomic re-attachment of the vitreous. Visual acuity (VA) was evaluated by comparing the Ocular Trauma Scores (OTS) system with BCVA (as assessed by Fisher's exact test).

RESULTS

Patients included 70 (65.42%) boys and 37 (34.58%) girls (mean, 7.84 ± 2.31 years). Mean follow-up time was 13.31 ± 3.15 months. Zone-1 injuries accounted for 15 of 107 (14.02%) cases, while Zones-2 and -3 accounted for 69 of 107 (64.49%), and 23 of 107 (21.50%) cases, respectively. Lens trauma was noted in 53 of 107 (49.53%) eyes. Our analysis showed that the 6-month BCVA, as assessed by OTS, differed significantly between groups OTS-1 (p = 0.001) and OTS-2 (p = 0.012). No significant difference was observed in group OST-3 (p = 1.000). Total retinal attachment was achieved in 99 of 107 eyes (92.52%).

CONCLUSIONS

Following combined PPV/SOT for post-traumatic endophthalmitis, VAs were not only favorable, but also often better than those predicted by OTS. Increased awareness of the very serious nature of endophthalmitis is expected to help in the development of a comprehensive strategy designed to educate both parents and children, and to minimize the number of preventable pediatric OGIs.

Pediatric ocular trauma score as a prognostic tool in the management of pediatric traumatic cataracts

OBJECTIVE

To introduce and validate the pediatric ocular trauma score (POTS) - a mathematical model to predict visual outcome trauma in children with traumatic cataract METHODS: In this retrospective cohort study, medical records of consecutive children with traumatic cataracts aged 18 and below were retrieved and analysed. Data collected included age, gender, visual acuity, anterior segment and posterior segment findings, nature of surgery, treatment for amblyopia, follow-up, and final outcome was recorded on a precoded data information sheet. POTS was derived based on the ocular trauma score (OTS), adjusting for age of patient and location of the injury. Visual outcome was predicted using the OTS and the POTS and using receiver operating characteristic (ROC) curves.

RESULTS

POTS predicted outcomes were more accurate compared to that of OTS (p = 0.014).

CONCLUSION

POTS is a more sensitive and specific score with more accurate predicted outcomes compared to OTS, and is a viable tool to predict visual outcomes of pediatric ocular trauma with traumatic cataract.

Better Visual Outcome by Intraocular Lens Ejection in Geriatric Patients with Ruptured Ocular Injuries

Ocular trauma is one of the leading causes of visual impairment worldwide. Because of the popularity of cataract surgeries, aged individuals with ocular trauma commonly have a surgical wound in their eyes. The purpose of this study was to evaluate the visual outcome of cases that were coincident with intraocular lens (IOL) ejection in the eyes with ruptured open-globe ocular injuries. Consecutive patients with open-globe ocular injuries were first reviewed. Patients’ characteristics, corrected distance visual acuities (CDVAs) over 3 years after the trauma, causes of injuries, traumatic wound patterns, and coexistence of retinal detachment were examined. The relationships between poor CDVA and the other factors, including the complications of crystalline lens and IOL ejection, were examined. A total of 105 eyes/patients [43 eyes with rupture, 33 with penetrating, 28 with intraocular foreign body (IOFB), and 1 with perforating injuries] were included. Rupture injuries were common in aged patients and were mostly caused by falls, whereas penetrating and IOFB injuries were common in young male patients. CDVAs of the eyes with rupture injuries were significantly worse than those of the eyes with penetrating or IOFB injuries. CDVA from more than 50% of the ruptured eyes resulted in no light perception or light perception to 20/500. CDVA of the ruptured eyes complicated by crystalline lens ejection was significantly worse than that of those complicated by IOL ejection. The wounds of the ruptured eyes complicated by IOL ejection were mainly located at the superior corneoscleral limbus, whereas those of the eyes complicated by crystalline lens ejection were located at the posterior sclera. There were significant correlations between poor CDVA and retinal detachment and crystalline lens ejection. These results proposed a new trend in the ocular injuries that commonly occur in aged patients; history of cataract surgery might affect the final visual outcome after open-globe ocular injuries.

Prognostic Factors for Visual Outcome in Traumatic Cataract Patients

Purpose. To investigate the prognostic factors for visual outcome in traumatic cataract patients. Methods. The demographic features of traumatic cataract patients in Central China were studied. The factors that might influence the visual outcome were analyzed. The sensitivity and specificity of OTS (ocular trauma score) in predicting VA were calculated. Results. The study enrolled 480 cases. 65.5% of patients achieved VA at >20/60. The factors associated with the final VA were initial VA, injury type, wound location, the way of cataract removal, and IOL implantation. The sensitivities of OTS in predicting the VA at NLP (nonlight perception), LP/HM (light perception/hand motion), and ≥20/40 were 100%. The specificity of OTS to predict the final VA at 1/200-19/200 and 20/200-20/50 was 100%. Conclusion. The prognostic factors were initial VA, injury type, wound location, cataract removal procedure, and the way of IOL implantation. The OTS has good sensitivity and specificity in predicting visual outcome in traumatic cataract patients in long follow-up.

Prognostic Factors for Open Globe Injuries and Correlation of Ocular Trauma Score in Tianjin, China

Purpose. To investigate prognostic factors that influence the final visual acuity (VA) and to correlate the ocular trauma score (OTS) with the final VA in open globe injuries. Methods. A retrospective review of 298 patients with open globe injuries admitted to Tianjin Medical University General Hospital was carried out from January 1, 2010, till December 31, 2014. Prognostic factors influencing the final VA in patients with open globe injuries and the correlation between OTS and the final VA were examined. Results. Three hundred and fourteen eyes from 298 patients with open globe injuries were analyzed. Males had a higher rate of open globe injury than females (83.56% versus 16.44%). Mean age was 45.46 ± 17.48 years (5–95 years). In a univariate analysis, prognostic factors influencing the final VA included initial VA, relative afferent papillary defect (RAPD), vitreous hemorrhage, lens injury, endophthalmitis, hyphema, retinal detachment, and the zone of injury. In a multiple logistic regression analysis, initial VA, RAPD, and the zone of injury were considered to be independent risk factors. The OTS correlated with final VA (r = 0.988, p = 0.000). Conclusion. In our study, the most important prognostic factors influencing the final VA were initial VA, RAPD, and the zone of injury. The OTS was of great importance for patients and ophthalmologists.