Objective: To evaluate the accuracy of the Classification and Regression Tree (CART) model in prognosticating visual outcomes of patients with open-globe injuries Methods: This was a retrospective, single-center, cohort study of patients with open-globe injuries seen over a two-year period. Purposive sampling of hospital medical records was done to collect data from both in- and out-patient cases. The CART algorithm was utilized to determine the predicted visual outcome for each case, and the accuracy of prognostication was measured by computing for sensitivity, specificity, positive predictive value, and negative predictive value. The area under the receiver operating characteristic curve was used to check its discriminatory capability. Results: A total of 65 eyes (65 patients) with the following diagnoses based on the Birmingham Eye Trauma Terminology (BETT) classification were included: penetrating eye injury (n=58), globe rupture (n=2), and intraocular foreign body (n=5). Majority were male patients (81.5%) in the 17-39 year age group (40%). The sensitivity and specificity of CART were 100% (95% CI 93.6 to 100%) and 77.8% (95% CI 40 to 97.2%), respectively, with an overall accuracy of 96.9% (95% CI 89.3 to 99.6%). Area under the curve (AUC) was statistically significant at 0.89 (95% CI 0.79 to 0.95), indicating that the CART model can discriminate vision survival versus no vision. Conclusion The CART model demonstrated high accuracy in prognosticating visual outcomes after an openglobe injury in the local setting. It may be used as a helpful tool to guide treatment decisions in open-globe injuries.
Eye Injuries, Penetrating

Background: Penetrating eye injury is common cause blind or many long-term complications later. One of the complications such as glaucoma in the eye. There were some research on glaucoma after penetrating eye injury, but no reports about the treatment of glaucoma. Objectives: To describe the clinical characteristics and assess the outcomes of surgery in the treatment of glaucoma after penetrating eye injury. Subjects and method: The author performed a prospective analysis of 32 eyes the underwent surgery causes by glaucoma after penetrating eye injury at Trauma department of National Institute of Ophthalmology. Follow up period: 6 months. Data was processed by using medical statistics methods on SPSS 10.5 software. Results: Of the 32 patients, 21 were men (65.6%) and 11 were women (34.4%). Localization of the injury: in the cornea 93.8%; lens damages 100%; vitreous organization 56.3%; retinal detachment 12.5%. Functional success (visual acuity >0.02): 18.8%, 4 eyes were enucleated. The normal intraocular pressure after surgery was 71.9%. Conclusion: The clinical characteristics of glaucoma after penetrating eye injury are complicated and multivariable. The rate of normal pressure after treatment was 71.9%.
Glaucoma/surgery ; Eye Injuries ; Penetrating ;

Human ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; EYE INJURIES ; EYE INJURIES, PENETRATING ; PENETRATING EYE INJURIES

Background: Severe penetrating eye injury is a common emergency in ophthalmology. Objectives: The evaluation results and complications following vitrectomy in severe penetrating injury in children. Subjects and method: This study included 136 eyes with penetrating eye injury, who were treated at the Trauma department of National Institute of Ophthalmology, Hanoi \ufffd?Vietnam from 1999-2000. Vitrectomy was performed through the limbal and pars plana in 135 patients, 105 boys and 30 girls. Results: Remove intraocular foreign body: 11%, procedure for retinal detachments: 14%. The common functional success (visual acuity of 5/2000 or better) rate was 55,1%. Functional success: absent retinal detachment: 60,7%; present: 21,1%. Anatomic success rate was 66,2%. 4 eyes (2,9%) were eviscerated. Complications of the surgery were: iridocyclite, edema of the cornea, hemorrhage, hyphema. Conclusion:Vitrectomy techniques showed its good effect in treating penetrating eye injury in children. Presence retinal damage and endophthalmitis have significant effect on the final visual outcomes.
Eye Injuries ; Penetrating/ surgery ; Vitrectomy ; Child ;

Taser guns are considered less lethal weapon than pistols. However, several cases and animal experiments reported injuries associated with Taser guns. This report describes the case of a patient who suffered a penetrating eye injury after being shot by a Taser gun. It is important for the emergency physician to understand potential injuries that can be caused by Taser guns.
Animal Experimentation ; Emergencies ; Eye Injuries, Penetrating ; Firearms ; Humans ; Weapons

The author experienced 96 cases of eyeball perforation from January 1980 to May 1982. Of those evaluated 24 cases of severe penetrating injuries involving vitreous gel were treated with pars plana vitrectomy. The conclusions were as follows: 1. Visual improvement was achieved in 45.B%, of the 24 patients with ocular penetrating injury treated by pars plana vitrectomy. 2. The prognosis was poorer in cases with scleral or corneoscleral injury than corneal penetrating injury. 3. The final visual prognosis was poorer in the 8 cases with large scleral laceration (more than 8mm) than in the other 16 cases. The visual acuity was limited to hand motion or less in 12 cases. 4. Those patients who were operated on between 2 weeks and 6 weeks after the injury had a better prognosis than others.
Eye Injuries/*surgery ; Humans ; Prognosis ; *Vitrectomy ; Wounds, Penetrating/*surgery

Between 1st January 1999 and 31st December 2000, 152 patients (156 eyes) with open-globe injuries were treated in the Department of Ophthalmology, Hospital Sultanah Aminah, Johor Bahru. The majority were male (88.2%), Malay (63.2%), from the Johor Bahru district (51.3%) and aged between 21 and 30 years (23.7%). Most injuries were workplace-related (41.4%). Lens injury, retinal detachment, endophthalmitis, intraocular foreign bodies and phthisis occurred in 40.4%, 15.4%, 14.7%, 12.2% and 11.5% of eyes respectively. A favourable visual outcome occurred in 55.4% of eyes. Prognostic factors for visual outcome include presenting visual acuity, relative afferent pupillary defect, wound location, lens injury, retinal detachment and endophthalmitis.
Eye Injuries, Penetrating/*epidemiology ; Hospitals, General ; Malaysia/epidemiology

No abstract available.
Eye Foreign Bodies/*etiology ; Eye Injuries, Penetrating/*etiology ; Humans ; Lens, Crystalline/*injuries ; Male ; *Metals

PURPOSE: Scleral buckles are frequently performed as an additional procedure in perforated ocular injury surgery, but little is known about their independent effect after ocular trauma. The authors made a posterior penetrating ocular injury model in rabbits to evaluate the isolated role of primary scleral buckle placement. METHODS: Twenty eyes underwent surgery. The penetrating injury consisted of two 5 mm circumferential incisions placed five clock hours apart and 7 mm behind the limbus. A segmental scleral buckle was placed over a randomly chosen penetrating injury site after wound closure. The degree of the fibrous proliferation, traction, and the presence of retinal detachment were evaluated on follow-up examination. After enucleation and fixation, tissue sectioning was performed including injury sites. The greatest dimension of the fibrous proliferation at both wound sites was measured. RESULTS: Two eyes were excluded from the study due to unsuccessful buckling. Four eyes developed a retinal detachment. The remaining 14 eyes showed varying degrees of proliferation and traction on the retina. The greatest dimension of the fibrous proliferation at the buckle site (1.69 +/- 0.29 mm) was significantly different from that at the non-buckle site (2.07 +/- 0.37 mm, P<0.05). CONCLUSION: Primary scleral buckle placement at the time of surgical repair reduces vitreous traction and decreases the degree of fibrous proliferation.
Eye Injuries, Penetrating* ; Follow-Up Studies ; Methods ; Rabbits ; Retina ; Retinal Detachment ; Tissue Fixation ; Traction ; Wounds and Injuries

OBJECTIVETo evaluate the therapeutic effects and complications of hydroxyapatite (HA) orbital implantation on patients after trauma-related surgeries.

METHODSRetrospective analysis was made from 211 cases (211 eyes) who underwent HA orbital implant placement after trauma-related enucleation or evisceration, including 68 cases of evisceration and primary HA implant placement, 77 cases of enucleation and HA implant placement wrapped with multi-windowed sclera, 66 cases of enucleation and HA implant placement free of wrapping. All the cases were followed up for 1-5 years to observe the therapeutic effects and major complications.

RESULTSFive of 211 cases had wound dehiscence. Ten cases had HA implants exposure, including 1 case suffering severe orbital infection and requiring HA implant removal. The implants exposure incidences by the three surgical methods were from 1.30% to 10.06% and averaged 4.74%. Significant difference was found in late exposure incidence and total incidence from the three methods (chi(2)=13.372, P < 0.01 and chi(2)=7.540, P < 0.05). Two cases had shrinkage of the lower fornix. Enophthalmos occurred in 1 case treated by method 1 and was corrected by implanting porous polyethylene (Medpor) plate into the bottom of orbit. In 210 cases, the artificial eye moved well and the cosmetic results were satisfactory.

CONCLUSIONSDifferent surgical methods have their own merit and disadvantage. Enucleation and placement of HA implant wrapped with multi-windowed sclera has corroborated fewer complications than others.

Adult ; Durapatite ; Eye Enucleation ; methods ; Eye Evisceration ; methods ; Eye Injuries, Penetrating ; surgery ; Female ; Humans ; Male ; Middle Aged ; Ophthalmologic Surgical Procedures ; methods ; Orbital Implants ; Prosthesis Implantation ; methods ; Retrospective Studies