Characteristics and outcomes of fall-related open-globe injuries in pseudophakic patients

Figures & data

Table 1 Circumstances and characteristics of injury

	N (%)
Location
Indoor	18 (69)
Outdoor	8 (31)
Home	16 (62)
Outside the home/not specified	10 (38)
Mechanism of injury
Rupture	22 (85)
Penetration	4 (15)
Material of impact
Floor/concrete/front porch	13 (50)
Furniture*	7 (27)
Other object**	6 (23)
Presenting BCVA*** (25)
NLP	4 (16)
LP/HM	17 (68)
CF	3 (12)
20/200	1 (4)
APD*** (13)	6 (46)
Hyphema	22 (85)
100% AC fill	11 (50)
50%–99% AC fill	6 (27)
<50% AC fill	5 (23)
360° SCH*** (24)	13 (54)
Iris injury	26 (100)
IOL damage	15 (58)
Expulsed IOL	11 (73)
Dislocated IOL	4 (27)
Periorbital ecchymosis/edema	19 (73)
Facial/lid laceration	12 (46)
Orbital fracture	7 (27)
VH	21 (81)
RD	12 (46)
PVR, delayed	6 (23)
Choroidal detachment/rupture	10 (38)
Wound location
Zone I	18 (69)
Zone II	17 (65)
Zone III	6 (23)
Wound characteristics
>10 mm	14 (54)
Uveal prolapse	22 (85)
Vitreous prolapse	13 (50)
6-month BCVA*** (25)
NLP/prosthesis	6 (24)
LP/HM	5 (20)
CF	7 (28)
<20/40 to ≥20/400	3 (12)
≥20/40	4 (16)
Final BCVA*** (25)
NLP/prosthesis	6 (24)
LP/HM	7 (28)
CF	5 (20)
<20/40 to ≥20/400	3 (12)
≥20/40	4 (16)

Notes:

* Furniture: table (4), night stand (2), and chair (1).

** Other objects: walker, car door, cup, fork, thermostat.

*** Numbers in parentheses denote total number of patients for whom the data were available if <26.

Abbreviations: AC, anterior chamber; APD, afferent pupillary defect; BCVA, best-corrected visual acuity; CF, count fingers; HM, hand motion; IOL, intraocular lens; LP, light perception; NLP, no light perception; PVR, proliferative vitreoretinopathy; RD, retinal detachment; SCH, subconjunctival hemorrhage; VH, vitreous hemorrhage.

Figure 1 Ocular trauma score at the time of injury.

Abbreviations: BCVA, best-corrected visual acuity; ECCE, extracapsular cataract extraction; PE, phacoemulsification; PKP, penetrating keratoplasty.

Figure 2 Wound size (mm) at the time of injury.

Abbreviations: BCVA, best-corrected visual acuity; ECCE, extracapsular cataract extraction; PE, phacoemulsification; PKP, penetrating keratoplasty.

Table 2 Ocular trauma score at the time of injury

	N	Mean	SD	P-value
All patients	26	38.54	10.95
6-month and final BCVA ≥20/40	4	52.00	10.00	0.0017
6-month and final BCVA <20/40	21	35.85	9.14
6-month and final BCVA ≥20/400	7	51.29	7.87	<0.0001
6-month and final BCVA <20/400	18	33.69	7.01
No phthisis	18	41.82	10.99	0.0240
Phthisis at final follow-up	7	30.57	5.63
History of ECCE	10	39.50	12.92	0.7261
History of standard PE	16	37.86	9.76
History of PKP	4	36.50	7.77	0.4167
No PKP	22	38.95	11.60

Note: Bold indicates significant values, P<0.05.

Abbreviations: BCVA, best-corrected visual acuity; ECCE, extracapsular cataract extraction; PE, phacoemulsification; PKP, penetrating keratoplasty; SD, standard deviation.

Table 3 Wound size (mm) at the time of injury

	N	Mean	SD	P-value
All patients	26	9.81	7.20
6-month and final BCVA ≥20/40	4	3.63	1.70	0.0440
6-month and final BCVA <20/40	21	11.47	7.20
6-month and final BCVA ≥20/400	7	4.79	2.77	0.0145
6-month and final BCVA <20/400	18	12.44	7.37
No phthisis	18	9.50	3.84	0.0026
Phthisis at final follow-up	7	12.83	3.43
History of ECCE	10	9.50	3.84	0.8600
History of standard PE	16	10.04	9.03
History of PKP	4	11.25	2.50	0.6718
No PKP	22	9.53	7.83

Note: Bold indicates significant values, P<0.05.

Abbreviations: BCVA, best-corrected visual acuity; ECCE, extracapsular cataract extraction; PE, phacoemulsification; PKP, penetrating keratoplasty; SD, standard deviation.

Table 4 Inverse correlation (odds ratio <1) of visual outcomes with initial or delayed ocular findings using Fisher’s exact test

	P-value	Odds ratio
6-month and final BCVA ≥20/40, by wound ≥10 mm	0.0491	0.2941
6-month and final BCVA ≥20/40, by RD, initial presentation	0.0491	0.2941
6-month and final BCVA ≥20/400, by 360° SCH	0.0498	0.0800
6-month and final BCVA ≥20/400, by RD, initial presentation	0.0022	0.2143
6-month and final BCVA ≥20/400, by wound ≥10 mm	0.0181	0.0545
6-month and final BCVA ≥20/400, by RD, initial or delayed	<0.0001	0.1429
6-month and final BCVA ≥20/400, by PVR, delayed	0.0097	0.2500

Abbreviations: BCVA, best-corrected visual acuity; PVR, proliferative vitreoretinopathy; RD, retinal detachment; SCH, subconjunctival hemorrhage.

Table 5 Direct correlation (odds ratio <1) of visual and surgical outcomes with initial or delayed ocular findings using Fisher’s exact test

	P-value	Odds ratio
6-month and final BCVA <20/400, by 360° SCH	0.0498	12.5000
6-month and final BCVA <20/400, by RD, initial presentation	0.0498	12.5000
6-month and final BCVA <20/400, by RD, initial or delayed	0.0181	18.3333
6-month and final BCVA <20/400, by PVR, delayed	0.0310	3.0000
≥2 surgeries needed, by hyphema 100%	0.0345	2.7500
≥2 surgeries needed, by IOL damage	<0.0001	2.5000
≥2 surgeries needed, by expulsed IOL	0.0023	5.5000

Abbreviations: BCVA, best-corrected visual acuity; IOL, intraocular lens; PVR, proliferative vitreoretinopathy; RD, retinal detachment; SCH, subconjunctival hemorrhage.