عوامل موثر در آسيب هاي بازچشمي از نظر بينايي ، آناتومي و حفظ چشم

VISUAL OUTCOMES AND OCULAR SURVIVAL IN OPEN-GLOBE INJURIES

Purpose: To determine factors that affect and predict final visual acuity, retinal attachment, and ocular survival after open-globe injuries. Methods: One-hundred sixteen eyes with open globe injuries were evaluated longitudinally from September 2001to February 2004. Age, sex, involved eye, best corrected visual acuity (BCYA), afferent papillary defect (APD), size and location of laceration, cataract, iris prolapsed, vitreous prolapsed, retinal detachment (RD), intraocular forgien body (IOFB), deep vitrectomy, and type of injury were evaluated as predisposing factors by logistic regression analysis for final visual acuity and retinal attachment and by Chi Square for survival rate. Results: Enucleation was performed in 16 eyes (14%). Low initial visual acuity, RD, arid deep vitrectomy were detected as statistically significant risk factors for final visual acuity of 20/200 or less. Positive APD and deep vitrectomy were statistically significant risk factors for final RD. BCYA of 20/300 or less, laceration size more than 10 mm, scleral and corneoscleral lacerations, vitreous prolapsed, vitreous hemon-hage, RD, and sharp injury were risk factors for enucleation. Conclusion: Low BCYA, positive APD, and deep vitrectomy are risk factors for final low visual acuity. RD and deep vitrectomy are risk factors for final RD. Low initial visual acuity, larger scleral lacerations, positive APD, and RD are negative factors for ocular survival.