A 4-year Retrospective Review of Open Glove Injuries in a London Major Trauma Centre
Author: Minnan Al-Khafaji
Base Hospital / Institution: Royal London Hospital
ePoster presentation
Abstract ID: 25-418
Purpose
The Royal London Hospital is one of four major trauma centres in London and one of the 5 North London referral centres for emergency ophthalmic injuries, such injuries impact all ages and can have devastating consequences.
Methods
A retrospective single centre review was conducted of all patients who underwent emergency primary repair of open globe injuries between January 2019 and December 2023. Data collected included patient demographics, mechanism, classification of injury, presenting and final best-corrected visual acuity (BCVA), number and types of secondary procedures, and associated adnexal injury.
Results
The mean patient age was 47 years, with a male to female ratio of 3.5:1. The leading mechanism of injury was assault (41.7%) followed by falls (22.2%) and accidental injuries (16.7%). Of those with follow up data (27/36) BCVA was 6/9 or better in 8.3%, 6/12 – 6/60 in 8.3%, and counting fingers to no perception of light (CF – NPL) in 58.3%; 41.7% being NPL.
Globe ruptures accounted for 72% of injuries, and 28% were lacerations (penetrating). No perforating lacerations or intraocular foreign bodies were identified. Adnexal injuries were present in 63.9% of cases, most commonly lid lacerations and orbital fractures, highlighting the frequent need for oculoplastic expertise in managing these complex presentations. Secondary procedures were required in 44.4% (16/36), with 43.8% of these undergoing plate insertion. All plate insertions were successfully performed without the need for revision surgery. One patient had an evisceration.
In this cohort 30.5% were regularly followed up in outpatient clinics,11.1% were lost to follow-up. A further 13.9% were referred onwards to specialist services (e.g. vitreoretinal). Notably, 27.8% did not attend (DNA) their scheduled post-discharge outpatient appointments.
Conclusion
Open globe injury persists as a major contributor to ocular morbidity. These findings reinforce the clinical significance of such life changing injuries and highlight the need to increase the likelihood of patient engagement with the services
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Shaman | Dolly | Royal London Hospital |
| Nikhil | Cascone | Royal London Hospital |
