Yang Luqian, Ji Shuming, Zhao Yan, Song Yue, Liu Xueni, Ji Hongpei
Department of Ophthalmology, Guizhou Provincial People's Hospital, No.83, Zhongshan Road, Nanming District, Guiyang, Guizhou Province, 550002, China.
Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, China.
BMC Ophthalmol. 2025 Jan 13;25(1):16. doi: 10.1186/s12886-025-03845-y.
We aimed to investigate the occurrence and factors influencing early visual acuity (VA) outcomes and reoperation rates in patients with open globe injuries (OGI) and develop a nomogram for predicting early visual acuity outcomes and reoperation rate.
We conducted a retrospective review of data from 121 patients with treated OGI. Relevant information of all patients with OGI were collected after a 1-month timeframe post-surgery. Continuous variables were described using descriptive statistics, while categorical variables were described via frequency distributions between different groups. Model performance was evaluated using receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA).
There were significant differences between patients with reoperation group and patients without reoperation in term of gender, initial visual acuity, length of stay, and Birmingham Eye Trauma Terminology (BETT) types of injury. The result showed that initial VA, laterality, the BETT types of injury, location, retinal detachment, orbital CT, and intraoperative changes were related to the VA outcome, and initial VA is the most significant factor. Constructed nomogram based on those variables had a good efficiency in predicting the VA outcome. We obtained eight variables related to reoperation, including initial VA, age, length of stay, Gender, BETT, iris prolapse, retinal detachment, and type of anesthesia, and age is the most important factor. The nomogram based on those variables had a good efficiency for predicting the reoperation. Furthermore, the DCA showed that utilizing a reference threshold of 0.71 for VA outcomes and 0.79 for reoperation rates may offer clinical net benefit.
Our models showcase significant predictive efficacy in evaluating early VA outcome and reoperation rate, offering valuable insights to ophthalmologists in their clinical decision-making endeavors.
我们旨在研究开放性眼球损伤（OGI）患者早期视力（VA）结果及再次手术率的发生情况和影响因素，并制定一个列线图来预测早期视力结果和再次手术率。
我们对121例接受治疗的OGI患者的数据进行了回顾性分析。所有OGI患者的相关信息在术后1个月时收集。连续变量采用描述性统计进行描述，分类变量通过不同组间的频率分布进行描述。使用受试者工作特征（ROC）曲线、校准曲线和决策曲线分析（DCA）评估模型性能。
再次手术组和未再次手术组患者在性别、初始视力、住院时间和伯明翰眼外伤术语（BETT）损伤类型方面存在显著差异。结果表明，初始视力、患侧、BETT损伤类型、位置、视网膜脱离、眼眶CT和术中变化与视力结果相关，其中初始视力是最显著的因素。基于这些变量构建的列线图在预测视力结果方面具有良好的效率。我们获得了与再次手术相关的八个变量，包括初始视力、年龄、住院时间、性别、BETT、虹膜脱垂、视网膜脱离和麻醉类型，其中年龄是最重要的因素。基于这些变量的列线图在预测再次手术方面具有良好的效率。此外，DCA显示，将视力结果的参考阈值设定为0.71，再次手术率的参考阈值设定为0.79可能会带来临床净效益。
我们的模型在评估早期视力结果和再次手术率方面显示出显著的预测效力，为眼科医生的临床决策提供了有价值的见解。
