@article {1661614,
	title = {Effect of time to operative repair within twenty-four hours on visual acuity outcomes for open globe injuries},
	journal = {Eye (Lond)},
	volume = {37},
	number = {11},
	year = {2023},
	month = {2023 Aug},
	pages = {2351-2355},
	abstract = {PURPOSE: Convention is to perform open globe injury (OGI) repair within 24 h to minimize risk of endophthalmitis. However, there are limited data assessing how time to operative repair (OR) within 24 h impacts postoperative visual acuity (VA). METHODS: Manual retrospective chart review of 633 eyes at Massachusetts Eye and Ear (MEE) with a diagnosis of OGI between 2012 and 2022. Inclusion criteria were primary repair <= 24 h after injury and >=1 month\&nbsp;follow-up. Multivariate regression analysis was conducted with postoperative VA as primary outcome. RESULTS: Of the subjects, 489 (77.3\%) were male and 496 (78.4\%) were white. Demographics of OGI wounds included 320 (50.6\%) rupture and 313 (49.4\%) laceration; 126 (19.9\%) with rAPD, 189 (29.9\%) zone 3 injuries, 449 (71.2\%) uveal prolapse, and 110 (17.4\%) intraocular foreign body. Final postoperative LogMAR VAs consisted of 31\% with a VA \&lt; 1.7, 9\% with a VA of 1.9, 18\% with a VA of 2.3, 27\% with a VA of 2.7, and 11\% with a VA of 3.0. Multivariate analysis showed no significant correlation between time to OR and postoperative VA (p = 0.800) [95\%CI: -0.01,0.01]. Older age (p \&lt; 0.001) [95\%CI: 0.00,0.01], worse presenting VA (p \&lt; 0.001) [95\%CI: 0.17,0.32], rAPD (p \&lt; 0.001) [95\%CI: 0.65,1.0], mechanism of rupture (p \&lt; 0.001) [95\%CI: 0.19,0.54], higher zone of injury (p \&lt; 0.001) [95\%CI: 0.25,0.45], and uveal prolapse (p = 0.003) [95\%CI: 0.09,0.42] were significantly associated with worse final VA. CONCLUSIONS: Time to repair of OGIs within 24 h does not influence final VA. Optimization of surgical and patient factors may contribute more significantly to final VA than prioritizing more rapid time to OR.},
	keywords = {Eye, Eye Injuries, Penetrating, Female, Humans, Male, Prognosis, Random Amplified Polymorphic DNA Technique, Retrospective Studies, Visual Acuity},
	issn = {1476-5454},
	doi = {10.1038/s41433-022-02350-6},
	author = {Makhoul, Kevin G and Bitar, Racquel A and Armstrong, Grayson W and Weinert, Marguerite C and Ivanov, Alexander and Kahale, Francesca and Ta, Thong and Lorch, Alice C}
}
