J Korean Ophthalmol Soc.  2020 Sep;61(9):983-991. 10.3341/jkos.2020.61.9.983.

The Role of Orbital Computed Tomography as a Prognostic Indicator for Open Globe Injury

• Yoon JH
• Son BJ

• KMID: 2506471
• DOI: http://doi.org/10.3341/jkos.2020.61.9.983

Abstract

Purpose
To study the clinical role of preoperative orbital computerized tomography (CT) in determining initial surgery in patients with open globe injuries.
Methods
This is a retrospective study that evaluated patients who underwent an operation for single-eye open-globe injury after orbital CT and were followed up for at least one year. Patients were divided into two groups: a group with anatomical failure that underwent enucleation, evisceration, or phthisis bulbi and a group with anatomical success. The correlations with preoperative CT findings and clinical outcomes were compared between the two groups.
Results
A total of 122 cases of open globe injury were included. Comparing preoperative CT results between the two groups, anatomical failure was correlated with the CT findings of intraocular hemorrhage (odds ratio, 5.0; 95% confidence interval [CI], 2.0-15.4), orbital wall fracture, and a reduction in eyeball volume (all p < 0.05). In the anatomical failure group, the average volume and axial length of the eyeball decreased by 28% and 16%, respectively, in traumatic eyes compared with non-traumatic eyes.
Conclusions
Orbital CT is a useful tool for evaluating the extent of open globe injury. If the prognostic factors indicate poor results, including intraocular hemorrhage, orbital wall fracture, or a severe decrease in the volume of the injured eye in orbital CT scans, primary enucleation or evisceration should be considered carefully, based on consultations with patients and their caregivers.

Keyword

Computerized tomography; Enucleation; Open-globe injury; Phthisis bulbi; Prognosis