Glyxambi
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 
  • Users Online: 444
  • Home
  • Print this page
  • Email this page
ORIGINAL ARTICLE
Year : 2013  |  Volume : 61  |  Issue : 10  |  Page : 541-545

Pre-operative variables affecting final vision outcome with a critical review of ocular trauma classification for posterior open globe (zone III) injury


1 National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
2 Ministry of Health Holdings, Singapore

Correspondence Address:
Rupesh Agrawal
Department of Ophthalmology, Tan Tock Seng Hospital, 308433
Singapore
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.121066

Rights and Permissions

Purpose: To identify pre-operative variables affecting the outcome of posterior open globe (zone III) injuries. Secondary objective was to re-look at the definition or landmarks for zone III injury and its clinical significance for predicting visual prognosis following open globe injury. Materials and Methods: Retrospective review of medical records of all hospitalized patients with surgical repair of open globe injury over last 10 years at a tertiary referral eye care center in Singapore. Out of 172 eyes with open globe injury, 28 eyes (16.3%) with zone III injury was identified and reviewed further. Pre-operative visual acuity (VA) and other variables, extent of scleral wound in reference to rectus insertion, relative afferent pupillary defect (RAPD) and final vision outcome were recorded. Results: Median age was 37 years with male predilection (92.9%). Mean follow-up was 12.9 months. Pre-operative VA was no light perception (NLP) in 16 (57.1%) eyes. Final VA remained NLP in 14 eyes (50.0%). The factors contributing to poor post-operative vision based on univariate regression analysis were the presence of RAPD, poor pre-operative VA, blunt trauma, extent of trauma, associated traumatic cataract, hyphema, vitreous loss and associated vitreo-retinal trauma. Further on, zone III injuries with scleral wound limited anterior to rectus insertion (6 eyes) had better vision outcome than those with injuries extending beyond rectus insertion (22 eyes). Conclusion: Initial VA, blunt ocular trauma, visual axis involvement, loss of light perception, presence of RAPD, traumatic cataract, hyphema, vitreous loss were the important determinants for final visual outcome in patients with zone III injury. Wound extending posterior to rectus insertion has poorer outcome as those limited anterior to rectus insertion. We suggest that there may be a need to relook at zone III injuries with reference to rectus insertion for prognostic significance, and further studies are warranted.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed2176    
    Printed46    
    Emailed3    
    PDF Downloaded419    
    Comments [Add]    

Recommend this journal