Factors Associated with Visual Outcome after Primary Repair of Open-Globe Injury by Ophthalmology Residents in Training in a Tertiary Eye Center

Suppapong Tirakunwichcha,1 Pear Pongsachareonnont2 1Ophthalmic Plastic and Reconstructive Surgery Unit, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; 2Vitreoretinal Research Unit, Depart...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Tirakunwichcha S, Pongsachareonnont P
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2021
Materias:
Acceso en línea:https://doaj.org/article/1b2e3011d294427da2b94b360e9dc806
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:doaj.org-article:1b2e3011d294427da2b94b360e9dc806
record_format dspace
spelling oai:doaj.org-article:1b2e3011d294427da2b94b360e9dc8062021-12-02T17:05:58ZFactors Associated with Visual Outcome after Primary Repair of Open-Globe Injury by Ophthalmology Residents in Training in a Tertiary Eye Center1177-5483https://doaj.org/article/1b2e3011d294427da2b94b360e9dc8062021-03-01T00:00:00Zhttps://www.dovepress.com/factors-associated-with-visual-outcome-after-primary-repair-of-open-gl-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Suppapong Tirakunwichcha,1 Pear Pongsachareonnont2 1Ophthalmic Plastic and Reconstructive Surgery Unit, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; 2Vitreoretinal Research Unit, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, ThailandCorrespondence: Suppapong Tirakunwichcha Email suppapong@gmail.comPurpose: To assess factors associated with visual outcome after open-globe injury (OGI) repair by trainees.Methods: In this observational study, charts of OGIs repaired by trainees at King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok were retrospectively reviewed. Preoperative, intraoperative, and postoperative outcomes (day 1, month 1, and month 6 postoperation) were analyzed.Results: A total of 78 OGIs presented in a 10-year period. A biphasic pattern was found among the young and the elderly. Approximately 73.6% of the cases had had surgical repair outside office hours. A majority of cases had been caused by machinery and hammers, and had visual acuity (VA) < 20/200. Three cases were reported as having been unsuccessful intraoperatively for globe repair. A fifth of the cases required evisceration/enucleation within 2 weeks of presentation. Presenting VA worse than hand motion was associated with the risk of evisceration/enucleation (OR 14.5, P=0.013). VA improved at 6 months postoperation to the range of counting fingers and 20/200 (OR 15.6, P< 0.01). High ocular trauma scores (OTSs) was associated with lower risk of evisceration/enucleation, and 12% retinal detachment (RD) was discovered, of which 90% occurred within 1 month after OGI repair.Conclusion: Most OGIs were efficiently managed by the trainees, seldomly requiring assistance from subspecialists. Poor initial VA was associated with high risk of visual loss, whereas higher OTSs were inversely related to lower risk of evisceration or enucleation. There was a higher percentage of participants with final VA of 20/100– 20/20 than the preoperative period. Precaution and careful evaluation of RD in the early postoperative period is recommended.Keywords: evisceration, traumatic open-globe injury, residency training, ruptured globeTirakunwichcha SPongsachareonnont PDove Medical Pressarticleeviscerationtraumatic open globe injuryresidency trainingruptured globeOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 1173-1181 (2021)
institution DOAJ
collection DOAJ
language EN
topic evisceration
traumatic open globe injury
residency training
ruptured globe
Ophthalmology
RE1-994
spellingShingle evisceration
traumatic open globe injury
residency training
ruptured globe
Ophthalmology
RE1-994
Tirakunwichcha S
Pongsachareonnont P
Factors Associated with Visual Outcome after Primary Repair of Open-Globe Injury by Ophthalmology Residents in Training in a Tertiary Eye Center
description Suppapong Tirakunwichcha,1 Pear Pongsachareonnont2 1Ophthalmic Plastic and Reconstructive Surgery Unit, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; 2Vitreoretinal Research Unit, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, ThailandCorrespondence: Suppapong Tirakunwichcha Email suppapong@gmail.comPurpose: To assess factors associated with visual outcome after open-globe injury (OGI) repair by trainees.Methods: In this observational study, charts of OGIs repaired by trainees at King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok were retrospectively reviewed. Preoperative, intraoperative, and postoperative outcomes (day 1, month 1, and month 6 postoperation) were analyzed.Results: A total of 78 OGIs presented in a 10-year period. A biphasic pattern was found among the young and the elderly. Approximately 73.6% of the cases had had surgical repair outside office hours. A majority of cases had been caused by machinery and hammers, and had visual acuity (VA) < 20/200. Three cases were reported as having been unsuccessful intraoperatively for globe repair. A fifth of the cases required evisceration/enucleation within 2 weeks of presentation. Presenting VA worse than hand motion was associated with the risk of evisceration/enucleation (OR 14.5, P=0.013). VA improved at 6 months postoperation to the range of counting fingers and 20/200 (OR 15.6, P< 0.01). High ocular trauma scores (OTSs) was associated with lower risk of evisceration/enucleation, and 12% retinal detachment (RD) was discovered, of which 90% occurred within 1 month after OGI repair.Conclusion: Most OGIs were efficiently managed by the trainees, seldomly requiring assistance from subspecialists. Poor initial VA was associated with high risk of visual loss, whereas higher OTSs were inversely related to lower risk of evisceration or enucleation. There was a higher percentage of participants with final VA of 20/100– 20/20 than the preoperative period. Precaution and careful evaluation of RD in the early postoperative period is recommended.Keywords: evisceration, traumatic open-globe injury, residency training, ruptured globe
format article
author Tirakunwichcha S
Pongsachareonnont P
author_facet Tirakunwichcha S
Pongsachareonnont P
author_sort Tirakunwichcha S
title Factors Associated with Visual Outcome after Primary Repair of Open-Globe Injury by Ophthalmology Residents in Training in a Tertiary Eye Center
title_short Factors Associated with Visual Outcome after Primary Repair of Open-Globe Injury by Ophthalmology Residents in Training in a Tertiary Eye Center
title_full Factors Associated with Visual Outcome after Primary Repair of Open-Globe Injury by Ophthalmology Residents in Training in a Tertiary Eye Center
title_fullStr Factors Associated with Visual Outcome after Primary Repair of Open-Globe Injury by Ophthalmology Residents in Training in a Tertiary Eye Center
title_full_unstemmed Factors Associated with Visual Outcome after Primary Repair of Open-Globe Injury by Ophthalmology Residents in Training in a Tertiary Eye Center
title_sort factors associated with visual outcome after primary repair of open-globe injury by ophthalmology residents in training in a tertiary eye center
publisher Dove Medical Press
publishDate 2021
url https://doaj.org/article/1b2e3011d294427da2b94b360e9dc806
work_keys_str_mv AT tirakunwichchas factorsassociatedwithvisualoutcomeafterprimaryrepairofopenglobeinjurybyophthalmologyresidentsintraininginatertiaryeyecenter
AT pongsachareonnontp factorsassociatedwithvisualoutcomeafterprimaryrepairofopenglobeinjurybyophthalmologyresidentsintraininginatertiaryeyecenter
_version_ 1718381776851697664