Abstract
Purpose
The aim of this study was to use the Ocular Trauma Score (OTS) to review and analyze all the open globe injuries (OGIs) that presented to Brooke Army Medical Center (BAMC) from July 2011 to March 2017, and whether or not the OTS can be used to predict enucleation or evisceration.
Methods
Retrospective chart review was performed through the medical record systems at BAMC for all OGIs from July 2011 to March 2017. This study was not performed on wartime patients. The primary outcome measures were the variables in the OTS and need for enucleation or evisceration.
Results
A total of 126 OGIs in 125 patients were identified from July 2011 to March of 2017. A lower calculated OTS was negatively associated with the outcome variables. A total of 25 cases resulted in enucleation or evisceration (19.8%). Of these, 17 underwent enucleation and 8 underwent evisceration. The average OTS for all eyes was 37.15, and the average OTS for eyes resulting in enucleation or evisceration was 22. Retinal detachment (RD), afferent pupillary defect (APD), globe rupture, globe perforation, and presenting visual acuity (VA) were all found to be statistically significant risk factors in patients who underwent enucleation or evisceration.
Conclusions
The present study shows that the OTS and the OTS pre-operative variables can help predict the likelihood that an OGI will ultimately result in enucleation or evisceration. Our study shows that the OTS is a valuable tool to use when evaluating OGI and can help in evidence-based counseling.
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Acknowledgments
Kurt Edwards, COL, USA, MD
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Research involving human participants and/or animals
All procedures performed in studies involving human participants were in accordance with the ethical standards of the office of the Institutional Review Board (IRB), Department of Clinical Investigations at BAMC, and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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The study was granted a waiver of informed consent by the IRB board at BAMC as it involved no more than minimal risk to the individuals and their privacy. The data is Health Insurance Portability and Accountability Act (HIPAA) compliant. Demographic and clinical data from the initial examination, surgical charts, and follow-up visits were recorded in a de-identified database.
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The authors report no financial disclosures. The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of the Brooke Army Medical Center, the US Army Medical Department, the US Army Office of the Surgeon General, the Department of the Air Force, the Department of the Army or the Department of Defense, or the US Government.
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Previous presentations: Military Health System Research Symposium August 2017, Kissimmee Fl (poster), Excelsior Surgical Society October 2017, San Diego, CA (oral presentation)
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Brundridge, W., Reed, D., Santamaria, J. et al. Open globe trauma in a military hospital: a review of the Ocular Trauma Score to help predict enucleation or evisceration. Graefes Arch Clin Exp Ophthalmol 257, 1789–1793 (2019). https://doi.org/10.1007/s00417-019-04356-5
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DOI: https://doi.org/10.1007/s00417-019-04356-5