A 10-year Analysis of Trends in Open-Globe Injuries in Edmonton, Canada from 2009 to 2018

Authors:Stephen Carrell¹, Scott Andersen¹, Matthew Benson¹, Matthew Pietrosanu², Sylvia Chen¹.
¹University of Alberta, ²Department of Mathematical and Statistical Sciences, University of Alberta.

Author Disclosure Block:S. Carrell: None. S. Andersen: None. M. Benson: None. M. Pietrosanu: None. S. Chen: None.

Abstract Body:

Purpose: To identify and characterize the incidence and correlates of open globe injuries presenting to the Eye Institute of Alberta (EIA) at the Royal Alexandra Hospital in Edmonton, Alberta, Canada.
Study Design: A 10-year single center retrospective chart review.
Methods: All patients who underwent a traumatic globe rupture repair at the Eye Institute of Alberta (EIA) from January 2009 to December 2018 were identified using key search terms. Charts were individually assessed for key demographic variables: mechanism of injury, location of injury (Zone 1 = Cornea, Zone 2 = Sclera <5mm from the limbus, Zone 3 = Full thickness posterior to Zone 2), lens involvement, pre and post operative visual acuity, length of hospital stay, prophylactic antibiotics, and eye protection use. Patterns in globe rupture incidence over the 10-year period and across demographics were assessed using Poisson regression. Associations between the key demographic variables were also analyzed.
Results: In total, 556 traumatic open globe injuries were treated at the EIA From January 2009 to December 2018, resulting in an average of 4.63 per month over the ten-year period. The mean case age was 42 (SD=21.56) years, with 442 (79.5%) male and 114 (20.5%) female cases. Among cases where eye protection use was recorded (n=187), only 11% reported using eye protection at the time of trauma. Injuries involving zone 1 (63.0%) or zone 2 (28.5%) were equally prevalent between genders. However, the prevalence of injuries with zone 3 involvement was significantly higher in males (41.4%) than in females (29.8%).No significant long-term or seasonal trends in incidence rates were detected. Gender was most strongly associated with globe rupture incidence: the rate of males presenting for open globe rupture repair was 2.5 times higher than for females. This rate for individuals >35 years old was significantly higher than for those <35 years old by 18.1% for both genders.
Conclusions: Open-globe injuries remain a significant source of ocular morbidity at the EIA averaging just over one emergency case a week. Given the strong association with male gender and the infrequent use of eye protection, targeted public health strategies are necessary to diminish the burden of these sight-threatening injuries.