Prognostic factors influencing final visual acuity in open globe injuries.

Background: To investigate the factors that influence final visual acuity (VA) in open globe injuries.

Methods: The records of patients with open globe injuries who were followed for longer than 6 months between 1998 and 2009 in two different centers were retrospectively reviewed. The data collected included patients' demographics as well as their initial VA, wound location, mechanism and type of injury, clinical findings, and final best-corrected VA. Statistical analysis was conducted using univariate analysis and multiple logistic regression analysis.

Results: Of 313 patients, 73.2% were men, and the mean age was 32.01 years ± 21.04 years. Penetrating injury was the most common type of injury. Of 313 injuries, 212 were caused by sharp/projectile objects, and injuries most commonly occurred in the workplace. In a univariate analysis, the factors contributing to a final VA worse than 20/200 included being older than 50 years, injury in zone 2 or 3, blunt injury, rupture-type injury, poor initial VA, and the presence of endophthalmitis, retinal detachment, relative afferent papillary defect, hyphema, vitreous prolapse, and uveal prolapse. In a multiple logistic regression analysis in which all factors that may influence final VA were analyzed together, poor initial VA, retinal detachment, and vitreous prolapse were found to be statistically significant.

Conclusion: In this retrospective study, the most important factors influencing final VA were initial VA, retinal detachment, and vitreous prolapse, all of which are important with regard to informing the patient of the prognosis and determining the approach the physician will take.