Changes in the Clinical Manifestations of Ocular Injuries Induced by Power Lawn Mowers

Yeon Soo Kang; Jun Sung Lee; Yong Sok Ji

doi:10.3341/jkos.2016.57.3.492

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Kang, Lee, and Ji: Changes in the Clinical Manifestations of Ocular Injuries Induced by Power Lawn Mowers

Original Article

J Korean Ophthalmol Soc 2016;57(3):492-498.

Published online: 3 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.3.492

Changes in the Clinical Manifestations of Ocular Injuries Induced by Power Lawn Mowers

Yeon Soo Kang, MD, Jun Sung Lee, MD, PhD, Yong Sok Ji, MD, PhD

Department of Ophthalmology, Chonnam National University Medical School, Gwangju, Korea

Address reprint requests to Yong Sok Ji, MD, PhD, Department of Ophthalmology, Chonnam National University Hospital, #42 Jebong-ro, Dong-gu, Gwangju 61469, Korea, Tel: 82-62-220-6744, Fax: 82-62-227-1642, E-mail: redvein@naver.com

Received 22 October 2015 Revised 4 January 2016 Accepted 16 February 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate changes in the clinical manifestations of ocular injuries induced by power lawn mowers. Methods: In a retrospective study of 172 patients with ocular injuries induced by power lawn mowers in 2006, 2010, and 2014. Best corrected visual acuity (BCVA) at the time of presentation and 6 months after trauma, age, sex and seasonal distribution were analyzed. We assessed the degree of injury using slit lamp biomicroscopy, fundus examination, and computed tomography and analyzed the prognoses according to open/closed injury and, anterior/posterior segment injury. All patients underwent medical or surgical treatment, and the factors affecting final BCVA were analyzed.

Results

The ratio of closed injuries increased significantly (p = 0.027), as did the ratio of corneal erosion (p = 0.020), and, the ratio of corneal laceration decreased significantly (p = 0.014) over time. In the multivariate analysis, initial BCVA was the only risk factor of poor visual outcome in both open and closed injuries.

Conclusions

The proportion of open globe injury has decreased over time. In contrast, the proportion of simple injuries such as corneal erosion has increased in ocular injuries induced by power lawn mowers. Lower initial visual acuity was the only risk factor of poor visual outcome in both open and closed injuries.

Keywords: Closed globe injury, Ocular injury, Open globe injury, Power lawn mower, Visual outcome

References

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Table 1.

Baseline characteristics of patients

	2006 (n = 49)	2010 (n = 57)	2014 (n = 66)	p-value
Age (years)^*	57.31 ± 10.13	55.58 ± 11.70	58.79 ± 12.54	0.314
Sex (male/female)^†	47/2	54/3	64/2	0.823
Season^†
Spring (n)	6	7	10
Summer (n)	32	22	34	0.230
Fall (n)	11	28	22
BCVA at presentation^* (log MAR)	1.30 ± 1.21	1.26 ± 1.26	1.18 ± 1.28	0.869
Final BCVA^* (log MAR)^*	0.53 ± 0.79	0.73 ± 1.06	0.79 ± 1.09	0.389

Values are presented as mean ± standard deviation unless otherwise indicated.

BCVA = best corrected visual acuity; log MAR = logarithm of the minimum angle of resolution.

^* One-way analysis of variance;

^† Linear by linear association.

Table 2.

Type of injuries

	No. of injured eyes (%)			p-value^*
	2006 (n = 49)	2010 (n = 57)	2014 (n = 66)	p-value^*
Open injury (n, %)	26 (53.1)	18 (31.6)	20 (30.3)	0.027
Closed injury (n, %)	23 (46.9)	39 (68.4)	46 (69.7)

^* Linear by linear association.

Table 3.

Comparison of visual acuity according to type of injuries

	Open injury (n = 64)	Closed injury (n = 108)	p-value^*
BCVA at presentation (log MAR)	1.82 ± 1.22	0.90 ± 1.14	<0.01
Final BCVA (log MAR)	1.31 ± 1.25	0.33 ± 0.57	<0.01

Values are presented as mean ± SD unless otherwise indicated.

BCVA = best corrected visual acuity; log MAR = logarithm of the minimum angle of resolution.

^* Independent-t test

Table 4.

Location of injuries

	No. of injured eyes (%)			p-value^*
	2006 (n = 49)	2010 (n = 57)	2014 (n = 66)	p-value^*
Anterior segment (n, %)	32 (65.3)	44 (77.2)	52 (78.8)	0.232
Posterior segment (n, %)	17 (34.7)	13 (22.8)	14 (21.2)

^* Linear by linear association.

Table 5.

Comparison of visual acuity according to location of injuries

	Anterior segment (n = 128)	Posterior segment (n = 44)	p-value^*
BCVA at presentation (log MAR)	0.89 ± 1.12	2.26 ± 1.01	<0.01
Final BCVA (log MAR)	0.40 ± 0.72	1.57 ± 1.18	<0.01

Values are presented as mean ± SD unless otherwise indicated.

BCVA = best corrected visual acuity; log MAR = logarithm of the minimum angle of resolution.

^* Independent-t test.

Table 6.

Ocular diseases induced by injury

	No. of injured eyes (%)			p-value^*
	2006	2010	2014	p-value^*
Corneal erosion	16 (32.7)	25 (43.9)	36 (54.5)	0.020
Corneal laceration	23 (46.9)	11 (19.3)	16 (24.2)	0.014
Corneoscleral laceration	2 (4.1)	2 (3.5)	2 (3.0)	0.805
Scleral laceration	0 (0)	2 (3.5)	2 (3.0)	0.379
Conjunctival laceration	3 (6.1)	9 (15.8)	6 (9.1)	0.762
Microscopic hyphema	35 (71.4)	29 (50.9)	34 (51.5)	0.043
Gross hyphema	11 (22.4)	14 (24.6)	16 (24.2)	0.913
Intracorneal foreign body	9 (18.4)	4 (7.0)	7 (10.6)	0.307
Intraocular foreign body	13 (26.5)	9 (15.8)	10 (15.2)	0.150
Iris injury	21 (42.9)	15 (26.3)	17 (25.8)	0.068
Lens injury	20 (40.8)	14 (24.6)	18 (27.3)	0.154
Vitreous hemorrhage	12 (24.5)	11 (19.3)	14 (21.2)	0.734
Retinal injury	5 (10.2)	5 (8.8)	4 (6.1)	0.496

^* Linear by linear association.

Table 7.

Treatment methods

	No. of injured eyes (%)			p-value^*
	2006 (n = 49)	2010 (n = 57)	2014 (n = 66)	p-value^*
Medication (n, %)	18 (36.7)	28 (49.1)	34 (53.5)	0.255
Operation (n, %)	31 (63.3)	29 (50.9)	32 (51.5)

^* Linear by linear association.

Table 8.

Comparison of visual acuity according to treatment methods

	Medication (n = 80)	Operation (n = 92)	p-value^*
BCVA at presentation (log MAR)	0.77 ± 1.06	1.66 ± 1.26	<0.01
Final BCVA (log MAR)	0.31 ± 0.55	1.04 ± 1.17	<0.01

Values are presented as mean ± SD unless otherwise indicated.

BCVA = best corrected visual acuity; log MAR = logarithm of the minimum angle of resolution.

^* Independent-t test.

Table 9.

Univariate and multivariate analyses of risk factors of poor visual outcome in open injury

	Univariate analysis		Multivariate analysis
	OR (95% CI)	p-value^*	OR (95% CI)	p-value^*
BCVA at presentation (log MAR)	1.814 (1.166-2.822)	0.008	1.685 (1.112-2.865)	0.045
Corneal laceration	1.333 (0.404-4.404)	0.637
Corneoscleral laceration	2.296 (0.390-13.536)	0.358
Scleral laceration	1.069 (0.141-8.093)	0.949
Microscopic hyphema	1.050 (0.369-2.984)	0.927
Gross hyphema	1.270 (0.434-3.718)	0.663
Intracorneal foreign body	0.124 (0.014-1.074)	0.058
Intraocular foreign body	5.622 (1.922-16.450)	0.002	2.609 (0.587-11.595)	0.208
Iris defect	1.111 (0.409-3.015)	0.836
Traumatic cataract	6.612 (2.213-19.760)	0.001	2.845 (0.727-11.123)	0.133
Capsular tear	2.500 (0.883-7.078)	0.084
Lens dislocation	1.067 (0.064-17.828)	0.964
Vitreous hemorrhage	4.948 (1.688-14.501)	0.004	2.250 (0.612-8.279)	0.222
Retinal break	2.400 (0.544-10.586)	0.248
Retinal detachment	3.429 (0.337-34.864)	0.298

OR = odds ratio; CI = confidence interval; BCVA = best corrected visual acuity; log MAR = logarithm of the minimum angle of resolution.

^* Logistic regression analysis.

Table 10.

Univariate and multivariate analyses of risk factors of poor visual outcome in closed injury

	Univariate analysis		Multivariate analysis
	OR (95% CI)	p-value^*	OR (95% CI)	p-value^*
BCVA at presentation (log MAR)	1.930 (1.193-3.123)	0.007	1.346 (1.717-2.526)	0.035
Corneal erosion	0.371 (0.110-1.255)	0.111
Conjunctival laceration	3.192 (0.840-12.131)	0.088
Microscopic hyphema	0.657 (0.195-2.216)	0.498
Gross hyphema	3.319 (0.940-11.721)	0.062
Iridodialysis	7.500 (1.747-32.205)	0.007	2.681 (0.435-16.542)	0.288
Traumatic cataract	1.364 (0.150-12.401)	0.783
Phacodonesis	1.364 (0.150-12.401)	0.783
Lens dislocation	10.333 (1.813-58.898)	0.009	3.331 (0.413-26.847)	0.259
Vitreous hemorrhage	7.500 (1.747-32.205)	0.007	3.284 (0.533-20.240)	0.200
Retinal break	8.636 (0.504-148.000)	0.137

OR = odds ratio; CI = confidence interval; BCVA = best corrected visual acuity; log MAR = logarithm of the minimum angle of resolution.

^* Logistic regression analysis.

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