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Kim, Lee, and Lee: Characteristics and Prognostic Factors of Open-Globe Injuries in Korea
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(10): 1505-1511.

Published online: 17 October 2012

DOI: https://doi.org/10.3341/jkos.2012.53.10.1505

Characteristics and Prognostic Factors of Open-Globe Injuries in Korea

Hye Sun Kim, MD, Sung Chul Lee, MD, Christopher Seungkyu Lee, MD

Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea.

Address reprint requests to Christopher Seungkyu Lee, MD. Department of Ophthalmology, Yonsei University Severance Hospital, #50 Yeonse-ro, Seodaemun-gu, Seoul 120-752, Korea. Tel: 82-2-2228-3570, Fax: 82-2-312-0541, sklee219@yuhs.ac

Received 8 November 2011       Accepted 12 August 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To characterize epidemiologically open-globe injuries and to identify prognostic factors for visual outcomes after open-globe injuries in Korea.

Methods

The medical records of 138 patients with open-globe injuries presenting to the Severance Hospital between January 2005 and June 2011 were retrospectively reviewed.

Results

Out of 138 patients, 85.5% were men. The types of injury included penetrating injury (44.2%), intraocular foreign body (15.9%), blunt injury (35.5%), and perforating injury (3.6%). The most common cause of injury was accidents at work (49.3%) and 60.9% of these injuries were a penetrating wound in zone I limited to the cornea. Predictors of poor visual outcome using univariate analysis included wound extended to posterior sclera, wound length of 10 mm or more, poor initial visual acuity of hand motion or less, and presence of associated ocular injuries at presentation including hyphema, lens injury, vitreous hemorrhage, and retinal detachment. Initial visual acuity and wound size were independent prognostic factors of visual outcome.

Conclusions

Accidents at work are the most important cause of open-globe injuries in Korea. Accordingly, protective measures such as appropriate eyewear and safety education at work are warranted. Initial visual acuity and wound size predicted favorable visual outcome.

Keywords: Corneal laceration, Eyeball rupture, Open globe injury, Scleral laceration

Figures and Tables

Figure 1
Ocular trauma classification. Zone I is confined to cornea and limbus. Zone II is limbus to 5 mm posterior into sclera. Zone III is posterior to 5 mm from the limbus.
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Figure 2
Sex and age distribution of the patients with open globe injury. Most of the injuries occur in the male group (85.5%). 65% of male injuries occur between age 30 and 59.
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Figure 3
Month and time distribution of the patients with open globe injury. There are clusters of injuries around noontime and during early evening.
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Figure 4
Cause of injury, n (%).
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Table 1
BETT system classification
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*Birmingham Eye Trauma Terminology Score.

Table 2
Visual outcome of surgical management in 138 patients with open globe injury
jkos-53-1505-i002

*No light perception, including 28 cases with eventual evisceration; †Light perception to hand motion; ‡Finger count; §Vision survival: final visual acuity of light perception or better; ∥Functional success: final visual acuity of 20/200 or better.

Table 3
Univariate analysis of potential predictive factors for vision survival and functional success
jkos-53-1505-i003

BETT score = Birmingham Eye Trauma Terminology Score; IOFB = intraocular foreign body; HM = hand motion; FC = finger count.

*Vision survival: final visual acuity of light perception or better; †Functional success: final visual acuity of 20/200 or better.

Table 4
Multivariate analysis of potential predictive factors for vision survival and functional success
jkos-53-1505-i004

HM = hand motion; FC = finger count.

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