This retrospective cohort study examined consecutive open globe injuries at a tertiary referral centre over a three year period. The aim of the study was to detail the clinical characteristics of open globe injuries and to explore their association with clinical outcomes, particularly postoperative wound related issues. Two hundred and sixty-seven eyes of 263 patients were included in the study. Of the cases, 82.5% were male and the mean age at presentation was 44.8 years. Penetrating injuries made up 68.2%, 31.1% globe ruptures and 0.7% perforating injuries. A total of 16.1% of eyes had an intraocular foreign body; 46.5% of these were in the posterior segment; 37.1% cases had a lens capsule breach. Regarding clinical outcomes following repair, over half of cases had improved VA at final follow-up. In total 47.2% of eyes had a final VA equal or better than 6/12 and 37.1% eyes had a final VA worse than 6/60. Factors that were associated with a poor VA included ≥50 years of age, globe rupture, presenting VA <6/60 and retinal detachment. Of the cases 16.4% had a wound leak following repair. Factors contributing to wound leak included stellate shaped wound and delayed presentation (>24 hours). Post traumatic endophthalmitis was seen in 3.7% cases. Risk factors for endophthalmitis included lens capsule breach, microbial keratitis and delayed presentation. The authors conclude that prompt and meticulous management of open globe injuries may reduce the complications of wound leak and endophthalmitis. 

Wound related complications and clinical outcomes following open globe injury repair.
Kong GYX, Henderson RH, Sandhu SS, et al.
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Anjali Gupta

Birmingham and Midland Eye Centre, Birmingham, UK.

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