OPEN GLOBE INJURIES: CLINICAL FEATURES AND OUTCOMES OF TREATMENT

Z.B. KHAYDAROV¹, SH.K. MAKHMADZODA¹, M.B. KARIMOV¹, KH.D. KARIM-ZADE¹, P.M. OSTANAEVA^1,2

¹Department of Ophthalmology, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
²LLC «Eye Microsurgery Nigoh», Dushanbe, Republic of Tajikistan

Objective: To examine the clinical features and visual outcomes of open globe injuries (OGI) and to evaluate the role of the Ocular Trauma Score (OTS) in the management of patients with OGI.

Methods: A retrospective study was conducted using the medical records of 561 patients (561 eyes) admitted to the Ophthalmology and Traumatology Department of the Shifobaksh National Medical Center in Dushanbe, Tajikistan, from January 1, 2018, to December 31, 2022, with a diagnosis of OGI. According to the Birmingham Eye Trauma Terminology (BETT) system, OGI are categorized into four types: rupture and laceration (penetrating injuries, perforating injuries, intraocular foreign bodies, abbreviated as IOFBs). The OTS was used to evaluate the severity of eye injuries and to assess the prognosis.

Results: The average age of the patients was 33 years, with 471 (84%) being men and 90 (16%) being women. There was no significant difference in average age between the sexes among patients hospitalized with OGI (p>0.05). Among patients, the highest frequency of OGI was among laborers and construction workers (49.0%), accounting for 275 cases, followed by agricultural workers (13.8%) with 77 cases. OGI was most common in individuals with incomplete secondary education, comprising 55.3% of the cases; this difference was statistically significant (χ²=315.81, p<0.001). In the localization of OGIs classified according to the BETT system, zone I was the most frequently injured site, accounting for 46.1% of cases, followed by zones I+II, which accounted for 31.2% of cases (p<0.001). IOFBs were reported in 104 cases (18.5%), with zone I being the most common site, occurring in 63.5% of these cases. Eyelid lacerations accompanied by canalicular lacerations were observed in 1.6% of the patients, while orbital bone injuries occurred in 0.3%.

Conclusion: Based on OGI location, zone I was the most common injury site, accounting for 46.1% of cases. Additionally, zone I was the most frequent site of IOFB penetration, occurring in 63.5% of cases. The incidence of penetrating injuries was notably higher in Group II, at 32.8%. Furthermore, globe ruptures were significantly more prevalent in age Groups I-III, with 52 eyes affected (80% of cases). Visual acuity improved in 58.1% of patients, and central vision was restored in 56.6%. This study validated the OTS scale for visual prognostic assessment. However, the lack of the IOFB parameter in this scale limited our ability to assess its impact on the results.

Keywords: Open globe injuries, OTS, types of injuries, intraocular foreign bodies, endophthalmitis.

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