Prognostic factors and visual outcomes of ruptured and lacerated globe injuries

Purpose: To identify prognostic factors related to ruptured and lacerated globes and compare the visual outcomes of these 2 mechanisms of injury. Methods: Medical records of patients with open-globe injuries referred to the Goldschleger Eye Institute between 2004 and 2010 were reviewed. Clinical parameters were summarized as defined by the ocular trauma score (OTS). All cases were classified as either ruptured or lacerated globes and a statistical analysis was performed in order to identify prognostic factors. Results: Medical records of 73 patients (55 male) were reviewed. Mean age of male injured patients was 33 years and of female injured patients was 64 years. Thirty-three percent of injuries were classified as ruptured globes. Males were mostly injured by a lacerating mechanism, compared to females (79.6% and 33.3%, respectively; p = 0.01). Mean logMAR at presentation after lacerated and ruptured globes was 1.42 ± 1.01 and 2.02 ± 0.91, respectively. Mean logMAR at the final follow-up visit after lacerated and ruptured globes was 0.65 ± 0.85 and 1.69 ± 1.10, respectively. Mean logMAR of the lacerated globes improved to a better extent compared to the ruptured ones (p = 0.046). The OTS was found to be a significant predictor of final mean logMAR for the lacerated globes (p<0.001), whereas mean logMAR at presentation was found to be the only predictive measure for ruptured globes (p<0.001). Conclusions: Ruptured and lacerated globes differ from each other in regard to prognostic factors and visual outcomes. We recommend distinguishing these 2 injury types in clinical practice as different open-globe injuries.