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Management of scleral tears with concurrent intraocular foreign bodies and factors affecting outcomes

Eye volume 38, pages 297–302 (2024)Cite this article

Subjects

Abstract

Aim

To report the clinical settings and factors predicting outcomes in scleral tears with concurrent retained intraocular foreign bodies

Methods

All cases with scleral and corneoscleral wounds with retained intraocular foreign bodies (RIOFB) from January 2014 to January 2021 were retrospectively analysed. Favourable anatomic outcome was defined as presence of globe integrity, attached retina, absence of hypotony and active inflammation at last visit. Favourable functional outcome was defined as final visual acuity (VA) > 20/200.

Results

Total 139 eyes were included. Mean age was 30.66 ± 13.32 years (median 29 years, IQR 17). Penetrating trauma accounted for 87.1%, rupture for 5.8%, perforation for 7.2%. In 5.8% of the eyes the injury involved zone I extending till Zone II while in 66.9% it involved Zone II and in 27.3% in Zone III. Snellen visual acuity at presentation was logMAR 2.97 ± 1.01 and at last visit was logMAR 2.38 ± 1.45 (p < 0.0001). Time between presentation and repair was 13.93 ± 19.56 h (median 7.6 h, IQR 17.17). Favourable functional outcome was seen in 34.5% eyes and 2/3rd achieved favourable anatomic outcome. Absence of endophthalmitis (OR = 6.25, p = 0.003) and ability to remove the foreign body (OR = 7.05, p = 0.003) were associated with a favourable anatomic outcome. Better presenting Snellen visual acuity (OR = 2.77, p = 0.003), manifest scleral tear (OR = 3.36, p = 0.04), and absence of endophthalmitis (OR = 50, p = 0.0009) were associated with a favourable functional outcome.

Conclusion

A third of the cases achieved favourable visual outcome while 2/3rd achieved favourable anatomic outcome. Absence of endophthalmitis is an important factor predicting both.

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Fig. 1: Slit lamp photo of an eye with open globe injury.
Fig. 2

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Data availability

All data from the study have been quoted in the results section of the manuscript.

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Funding

Hyderabad Eye Research Foundation.

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Authors and Affiliations

  1. Academy for Eye Care Education, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India

    Srishti Raksheeth Ramamurthy

  2. Anant Bajaj Retina Institute, Kallam Anji Reddy Campus, LV Prasad eye Institute, Hyderabad, India

    Srishti Raksheeth Ramamurthy

  3. Department of eyeSmart EMR & AEye, Kallam Anji Reddy Campus, LV Prasad eye Institute, Hyderabad, India

    Anthony Vipin Das

  4. Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore

    Rupesh Agrawal

  5. Moorfields Eye Hospital, NHS Foundation trust, London, UK

    Rupesh Agrawal

  6. Lee Kong Chian School of Medicine, Singapore, Singapore

    Rupesh Agrawal & Vivek Pravin Dave

  7. Singapore Eye Research Institute, Singapore, Singapore

    Rupesh Agrawal

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VPD conceived the idea of the manuscript, VPD, AVD and SRR collected and analysed the data, VPD, SRR, AVD and RA drafted and finalized the manuscript.

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Correspondence to Vivek Pravin Dave.

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Ramamurthy, S.R., Das, A.V., Agrawal, R. et al. Management of scleral tears with concurrent intraocular foreign bodies and factors affecting outcomes. Eye 38, 297–302 (2024). https://doi.org/10.1038/s41433-023-02679-6

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