Comparative study of 50 early- or late-onset retinal detachments after open or closed globe injury

Abstract

Purpose: To compare initial findings and final prognosis of retinal detachments (RDs) secondary to open or closed ocular injuries.

Methods: This prospective study comprised 50 consecutive patients with open (n = 25, with initial successful repair) or closed (n = 25) globe injuries during a 3-year period (2004-2007), with follow-up of at least 6 months (10.1 ± 5.8 months). The most common surgical procedure (76%) was pars plana vitrectomy.

Results: Clinical findings were similar in both groups for RD location and extent, frequency of macular involvement, number and nature of tears, and grade of proliferative vitreoretinopathy. Retinal detachment secondary to open/closed globe injury differed significantly, with longer time to onset after trauma, lower frequency in children, and higher rate of aphakia. Final anatomical and functional prognosis and rate of RD recurrence (25%) were similar in both groups. Good final visual prognosis (≥20/40) was significantly associated with initial visual acuity >20/200 and macula-on RD. Definitive redetachments (n = 3) were related to history of posttrauma endophthalmitis, posterior intraocular foreign body, or severe proliferative vitreoretinopathy.

Conclusion: Final prognosis was similar in eyes with RD secondary to open and closed globe injuries. The surgical technique depended mainly on lens status, type of retinal tear (dialysis and giant retinal tear), and the presence of preoperative proliferative vitreoretinopathy. Final prognosis (visual acuity ≥20/40) was associated with initial visual acuity >20/200 and macula-on status.