Moderate keratoconus with thick corneas.

PURPOSE: To describe two patients with moderate keratoconus and a corneal thickness exceeding 600 µm at the thinnest point. METHODS: Case report. RESULTS: In the first case, the steepest keratometric power was 51.50 diopters (D) in the right eye and 53.4 in the left eye and the thickness at the thinnest point was 658 and 625 µm, respectively. In the second case, the steepest keratometric power was 46.70 D in the right eye and 49.60 D in the left eye and the thickness at the thinnest point was 618 and 608 µm, respectively. CONCLUSIONS: Keratoconus may develop despite a very thick cornea, reinforcing the idea that biomechanical changes can signify an important factor in the development and progression of this pathology.

Late-onset corneal haze after intrastromal corneal ring implantation in an eye with previous topography-guided PRK.

PURPOSE: To report a case of late-onset corneal haze 3 months after intrastromal corneal ring segment (ICRS) implantation in an eye with previous transepithelial topography-guided photorefractive keratectomy (TG-PRK). OBSERVATIONS: A 40-year-old woman with stable keratoconus for 10 years underwent limited TG-PRK with mitomycin C in both eyes for mixed astigmatism. After four years, with atopic symptoms worsening and eye rubbing, the patient presented keratoconus progression in the left eye with increased irregular astigmatism. An ICRS was implanted with initial improvement in vision. Three months later severe subepithelial haze was observed along the ring groove. CONCLUSION AND IMPORTANCE: This is the first report of subepithelial haze after ICRS implantation. This report increases the evidence that permanent corneal wound healing changes occur after PRK and that late-onset haze may be triggered by corneal remodeling, as little inflammation or epithelial defect occurs after ICRS implantation. We do believe the detection of triggers, identification of risk factors of late-onset haze and appropriate preoperative counselling have an increasing importance due to the rising number of patients that have undergone PRK.

IOL Power Calculation After Radial Keratotomy Using the Haigis and Barrett True-K Formulas.

PURPOSE: To compare the accuracy of intraocular lens (IOL) power calculation in patients with previous radial keratotomy using the Haigis and Barrett True-K formulas. METHODS: In a retrospective cases series of patients with previous radial keratotomy and minimum follow-up of 1.2 months, preoperative data from an IOLMaster 500 or 700 (Carl Zeiss Meditec AG), the IOL power implanted, and the postoperative refraction were used to calculate the refractive prediction error. The primary outcomes were the mean absolute and arithmetic refractive prediction errors and the percentage of eyes with a refractive prediction error within ±0.50 and ±1.00 diopters (D). RESULTS: One hundred eight eyes were evaluated with a mean follow-up of 6.9 ± 4.9 months. The Haigis formula yielded a mean arithmetic refractive prediction error of -0.29 ± 1.00 D, which was significantly different than that of the Barrett True-K formula, which was -0.03 ± 0.96 D (P < .001). The mean absolute refractive prediction error was 0.80 ± 0.67 for the Haigis formula and 0.74 ± 0.60 for the Barrett True-K formula (P > .05). The percentages of eyes with a refractive prediction error within ±0.50 and ±1.00 D were 43.5% and 65.7% for the Haigis formula and 42.6% and 75.9% for the Barrett True-K formula, respectively (all P > .05). The subgroup analysis revealed that for flat corneas (K1 < 38.00 D), the Barrett True-K formula resulted in more hyperopic results than the Haigis formula. CONCLUSIONS: The Barrett True-K formula exhibited better arithmetic predictability than the Haigis formula; however, it showed a tendency for hyperopic results in very flat corneas. [J Refract Surg. 2020;36(12):832-837.].

Toric Artisan after transepithelial topography-guided photorefractive keratectomy for higher-order aberrations following intrastromal corneal ring segments in keratoconus - Trioptics.

We report a case of a 40-year-old female with keratoconus and high myopia who had previous ICRS implantation in both eyes (OU) and was intolerant to contact lenses. Manifest refraction was -8.50 -1.50 × 95 (20/25--) in right eye (OD) and -9.50 -2.50 × 60 (20/70--) in left eye (OS). A topography-guided transepithelial-photorefractive keratectomy (ttPRK) was performed to correct high-order aberrations on OS, resulting in corneal surface and coma improvement, and CDVA achieved 20/30. Correction of residual ametropia was performed with an iris-fixated toric phakic lens in OU. CDVA improved to 20/20- (Plano) in OD and 20/20- (Plano -1.00 90°) in OS. In conclusion, it is possible to rehabilitate a patient with keratoconus and high ametropia after intrastromal corneal ring segments (ICRS) implantation associating ttPRK and phakic lens ("Trioptics").

Photorefractive keratectomy and butterfly laser epithelial keratomileusis: a prospective, contralateral study.

PURPOSE: To evaluate results of two surface excimer laser refractive surgery techniques--photorefractive keratectomy (PRK) and butterfly laser epithelial keratomileusis (butterfly LASEK). METHODS: A prospective, randomized, double-masked study of 51 patients (102 eyes) who underwent laser refractive surgery. One eye of each patient was randomized to be operated with PRK and the fellow eye with butterfly LASEK. Patients were followed for 1 year. RESULTS: No significant difference between groups for distance uncorrected visual acuity (UCVA) (P = .559) was noted. At 1 year, 98% (50 eyes) in the PRK group and 96.1% (49 eyes) in the butterfly LASEK group reached UCVA of 20/20. Predictability, efficacy, safety, and stability were not statistically significant between groups. Safety index was 1.0 for PRK and 0.996 for butterfly LASEK. One eye in the butterfly LASEK group lost one line of best-spectacle corrected visual acuity. At 12 months, 94.1% (48 eyes) and 86.3% (44 eyes) in the PRK and butterfly LASEK groups (P = .188), respectively, had a spherical equivalent refraction of +/- 0.50 diopters. Slight haze was observed in both groups. A statistical difference in haze between the groups was observed only in the first postoperative month, with higher intensity in the butterfly LASEK group (0.18 +/- 0.39) compared to the PRK group (0.08+/- 0.21) (P = .04). CONCLUSIONS: Butterfly LASEK had similar predictability, efficacy, safety, stability, and haze incidence to PRK for the treatment of low to moderate myopia. However, on the second postoperative day, PRK showed better UCVA than butterfly LASEK.

Focal phototherapeutic keratectomy for the treatment of apical leucoma syndrome.

The following report describes a case of apical leucoma syndrome after hyperopic photorefractive keratectomy following hyperopic laser in situ keratomileusis and the subsequent treatment of this complication with focal phototherapeutic keratectomy. The patient underwent focal transepithelial phototherapeutic keratectomy of 70 mm ablation and 1.5 mm diameter after pupil and ablation offset correction. After 1 year, significant improvement in vision was observed and only slight residual opacity remained on biomicroscopy and optical coherence tomography. Focal phototherapeutic keratectomy was effective and safe for the treatment of this complication.

[Topographically-guided photorefractive keratectomy for the management of secondary hyperopia following radial keratectomy]. / Ceratectomia fotorrefrativa baseada em topografia para correção da hipermetropia secundária à ceratotomia radial.

PURPOSE: To describe a topographically guided photorefractive keratectomy technique for the management of secondary hyperopia following radial keratectomy. METHODS: A retrospective study was carried out in patients where a topographically guided photorefractive keratectomy technique was performed for the management of secondary hyperopia following radial keratectomy. The patients had preoperatively at least 3 diopters of hyperopia. The minimum follow-up was 3 months. RESULTS: Twenty-four eyes of 21 patients were evaluated. The mean age was 45.54+/-6.03 years (range 36 to 55 years). The average follow-up was 7.71+/-4.6 months (range 3 to 17 months). Preoperatively the average spherical equivalent was +3.92+/-1.57 (range +1.25 D to +7.75 D), and postoperatively it was -0.29+/-1.43 (range -3.75 D to +2.50 D) (p<0.01). Visual acuity of 20/25 or better was achieved in 45.83% of the eyes, 20/40 or better in 83.33% and 20/60 or better in 100%. All patients were satisfied with the results and stated subjective improvement in visual quality. CONCLUSION: Considering that it is a retreatment procedure performed in unstable and irregular corneas with high degrees of hyperopia, topographically guided photorefractive keratectomy showed good results and was safe and effective for the management of secondary hyperopia following radial keratectomy.

[Topographically supported customized ablation for the treatment of decentered laser in situ keratomileusis: report of three cases]. / Ablação corneana baseada em topografia para correção das descentralizações pós-laser in situ keratomileusis: relato de três casos.

Three cases of decentered laser in situ keratomileusis were successfully treated with the topographically supported customized ablation.

Removal of Persistent Cellular Deposits After Foldable Iris-Fixated Phakic IOL Implantation.

PURPOSE: To report a case of severe recurrent cellular deposits after Artiflex intraocular lens (Ophtec B. V., Groningen, The Netherlands) implantation. METHODS: Case report. RESULTS: A 25-year-old woman underwent uneventful Artiflex intraocular lens implantation in both eyes. After 3 months, severe cellular deposits were seen in the posterior surface of the lens in one eye. Topical steroids were administered, with temporary improvement. Four months later, the deposits recurred and did not respond to topical steroids. Corrected distance visual acuity lost five lines. Treatment by polishing the posterior surface of the lens 10 months after the initial implantation was performed and resulted in complete visual recovery. No recurrence of the deposits were observed after 2 years of follow-up. CONCLUSIONS: Persistent cellular deposits after Artiflex intraocular lens implantation may cause severe visual loss and may need surgical intervention. Polishing the posterior surface of the lens to mechanically remove the deposits was an effective long-term solution. [J Refract Surg. 2017;33(6):426-428.].

Photorefractive Keratectomy With Mitomycin C in Meesmann's Epithelial Corneal Dystrophy.

PURPOSE: To describe a case of Meesmann's epithelial corneal dystrophy that underwent photorefractive keratectomy (PRK) with mitomycin C. METHODS: Case report. RESULTS: A 36-year-old woman was evaluated for refractive surgery. She had a history of recurrent epithelial erosions and moderate visual loss over the past 10 years. Biomicroscopy revealed bilateral micro-cystic epithelial lesions and a diagnosis of Meesmann's epithelial corneal dystrophy was proposed. Corneal optical coherence tomography showed epithelial thickening with apparent intraepithelial cysts in the superficial layers. The patient's daughter's examination showed the same biomicroscopy pattern. PRK was performed. Epithelial healing was uneventful and only tiny microcysts could be observed after 3 months. However, complete recurrence of the intraepithelial cysts were observed after 1 year with visual acuity dropping due to residual refractive error. CONCLUSIONS: This case suggests that residual refractive error and recurrence of the cystic lesions and punctate erosions should be anticipated after PRK in patients with Meesmann's epithelial corneal dystrophy. [J Refract Surg. 2017;33(1):53-55.].

Sudden decrease in vision caused by liquefied after-cataract.

We report a case of sudden decrease to unilateral visual acuity in a 39-year-old patient who had extracapsular cataract surgery 5 years earlier. The decrease was caused by involvement of the visual axis because of a rare complication known as liquefied after-cataract. Treatment with a neodymium:YAG (Nd:YAG) laser was successfully performed. Although there was no rupture in the posterior capsule, the opacity disappeared and the visual acuity improved to 20/20. This new form of after-cataract can cause a sudden decrease in vision, and Nd:YAG laser treatment, even without a posterior capsule rupture, can be performed successfully.

Iridectomy of the anterior iris stroma using the vitreocutter during phacoemulsification in patients with iridoschisis.

We present a technique to manage iridoschisis. This technique for anterior iridectomy of the affected iris fibers avoids intraoperative obstruction of the phaco tip and prevents postoperative complications such as corneal decompensation and glaucoma. Before the capsulorhexis is created, a vitreocutter is inserted in the anterior chamber and used to cut the iris strands at the site of the iridoschisis, making an anterior sectorial stromal iridectomy and preserving the iris pigment epithelium. Phacoemulsification is then performed. After the pupil is constricted with carbacol, remnants of the loose anterior iris fibers are excised with the vitreocutter and the scleral incision is sutured.

The prevalence of ocular signs in acne rosacea: comparing patients from ophthalmology and dermatology clinics.

PURPOSE: To describe and compare the ocular signs in patients diagnosed with acne rosacea by the ophthalmologist with the ocular signs in the patients diagnosed with rosacea by the dermatologist. METHODS: We reviewed the medical records of 176 randomly selected patients diagnosed with rosacea at the University of California, Davis, Medical Center: 88 patients each from the Department of Dermatology and the Department of Ophthalmology. Of the 88 patients diagnosed with acne rosacea by a dermatologist, 22 (25%) had an ophthalmologic evaluation done prior to the study. In those patients without an ophthalmologic assessment, ocular complaints noted by the dermatologist were recorded. We recorded ocular signs including lid, conjunctival, corneal, episcleral, and scleral manifestations as well as charted observations of the iris, lens, intraocular pressures (IOPs), best corrected visual acuity (VA), and funduscopic examination. Age and sex were recorded from the initial ophthalmologic evaluation. The analysis was designed to compare the prevalence of signs and symptoms in two clinical settings. RESULTS: The prevalence of documented meibomian gland dysfunction (p < 0.001), telangiectasia (p = 0.004), and anterior blepharitis (p = 0.008) was significantly higher in ophthalmology patients when compared with dermatology patients. Of the conjunctival signs evaluated, only the presence of interpalpebral conjunctival hyperemia (p = 0.005) was found to be significantly higher in ophthalmology patients. The corneal, episcleral, scleral, and lens findings did not demonstrate a statistically significant difference between groups. CONCLUSION: The major and most easily observable ocular problems in rosacea patients presenting either to ophthalmology or dermatology are lid disease-related manifestations. As might be expected, eye signs and symptoms are more commonly noted in the eye clinic. A clinician's increased awareness of the common ocular findings of rosacea, however, may aid in earlier diagnosis and treatment of ocular rosacea.

Tacrolimus for the treatment of subepithelial infiltrates resistant to topical steroids after adenoviral keratoconjunctivitis.

PURPOSE: To describe the use of topical 0.03% tacrolimus in patients with symptomatic corneal subepithelial infiltrates (SEIs) secondary to adenoviral keratoconjunctivitis (AK) that were resistant to tapering of corticosteroid eye drops. METHODS: This was a prospective, nonrandomized, noncomparative interventional case series that included consecutive patients treated with tacrolimus for resistant SEIs after AK. The patients had active SEIs and corrected distance visual acuity (CDVA) of 20/25 or worse when treatment was initiated. The recorded data included age, sex, CDVA, intraocular pressure, duration and intensity of symptoms, biomicroscopy findings, and duration of therapy. The treatment was considered successful if there was a reduction in SEIs, as well as CDVA stabilization or improvement. The treatment was considered unsuccessful if the patient could not tolerate tacrolimus or if there was an increase in SEIs. RESULTS: Seven patients were included (10 eyes). The mean age was 36.7 ± 12.3 years. The mean duration of tacrolimus therapy was 8.8 ± 2.4 months, and the mean duration of follow-up was 13.6 ± 10.7 months. Treatment was successful in 8 eyes of 6 patients. One patient could not tolerate the medication. Statistically significant improvement in the CDVA was observed (from a mean of 0.29 to 0.07) (P = 0.001). No statistically significant changes in the intraocular pressure were observed (P = 0.574). SEI scores showed a significant reduction from 2.20 ± 0.92 to 0.25 ± 0.46 (P = 0.011). All patients who completed treatment had improvement in ocular symptoms. CONCLUSIONS: Topical 0.03% tacrolimus seemed to be an effective corticosteroid-sparing agent for the treatment of SEIs after AK.

Nodular epithelial hyperplasia after photorefractive keratectomy followed by corneal collagen cross-linking.

This study describes a case of nodular epithelial hyperplasia and stromal alterations in a patient with keratoconus who was submitted to topography-guided photorefractive keratectomy (PRK) followed by corneal collagen cross-linking. Debridement of the epithelial nodule was performed. After a 2-year followup, a new topography-guided PRK was indicated.

Focal phototherapeutic keratectomy for the treatment of apical leucoma syndrome / PTK focal para o tratamento da síndrome do leucoma apical

ABSTRACT The following report describes a case of apical leucoma syndrome after hyperopic photorefractive keratectomy following hyperopic laser in situ keratomileusis and the subsequent treatment of this complication with focal phototherapeutic keratectomy. The patient underwent focal transepithelial phototherapeutic keratectomy of 70 mm ablation and 1.5 mm diameter after pupil and ablation offset correction. After 1 year, significant improvement in vision was observed and only slight residual opacity remained on biomicroscopy and optical coherence tomography. Focal phototherapeutic keratectomy was effective and safe for the treatment of this complication.

RESUMO O relato a seguir descreve um caso da síndrome do Leucoma Apical após cirurgia ceratorrefrativa hipermetrópica depois de Laser hiperópico in situ keratomileusis, e o subsequente tratamento desta complicação com ceratectomia fototerapêutica focal. O paciente foi submetido à ceratectomia fototerapêutica focal transepitelial com ablação de 70 mm e diâmetro de 1,5 mm, após correção de offset pupilar. Depois de um ano, foi observada uma melhora significativa da acuidade visual permanecendo apenas leve opacidade residual na biomicroscopia e tomografia de coerência óptica. A ceratectomia fototerapêutica focal foi efetiva e segura para o tratamento desta complicação.

[Conjunctival autologous transplantation using fibrin glue in primary pterygium]. / Transplante autólogo de conjuntiva com uso de cola de fibrina em pterígios primários.

PURPOSE: To assess the rate of recurrence and complications after primary pterygium removal with conjunctival autograft using fibrin tissue adhesive. Secondarily, to compare these results with a retrospective series that underwent the same surgery using sutures. METHODS: A hundred and six eyes of 100 patients who underwent surgery with fibrin glue were prospectively studied, while 58 eyes of 51 patients who underwent surgery with sutures were retrospectively evaluated. Data included: age, gender, eye involved, location, grade and pterygium invasion and post-operative complications. Patients were followed for at least 5 months. RESULTS: Among 106 eyes undergoing surgery with fibrin glue, 12 (11.3%) had recurrence, including 4 (3.8%) conjunctival and 8 (7.5%) corneal. Mean age was statistically inferior in the recurrence cases compared to others (mean of 34.6 vs. 43.7; P=0.033). The time for recurrence ranged from 1.6 to 13.1 months (mean of 4.4). Among the corneal recurrences, 2 eyes had invasion beyond the limbus of up to 0.5 mm and 6 eyes from 0.6 to 1.0 mm. No eye underwent reoperation. Other complications included: transitory granuloma formation in 3 cases, partial graft detachment or slippage in 3 and dellen in 1. In the suture group, 15 eyes (25.9%) had recurrence, including 8 conjunctival (13.8%) and 7 (12.1%) corneal. The time for recurrence ranged from 0.7 to 9.7 months (mean 4.5 months). The conjunctival recurrence rate was statistically inferior in the glue group compared to the suture (P=0.023), however no statistically significant difference was observed in relation to corneal recurrence (P=0.232). CONCLUSION: The use of fibrin glue as an alternative to sutures in pterygium surgery was associated with good results and few complications. Despite a decrease in conjunctival recurrence rates, this technique does not appear to significantly decrease corneal recurrences.

[Therapeutic contact lenses and the advantages of high Dk materials]. / Lentes de contato terapêuticas e as vantagens dos materiais de alto Dk.

Therapeutic contact lenses are useful in a variety of ocular surface diseases. Their main indications are: to relieve the pain; protect ocular surface; promote corneal healing and epithelial regeneration; seal a leaking corneal wound and deliver ophthalmic drugs on the ocular surface. There are several kinds of lens designs and materials, and their choice is dependent on the specific disease to be treated, the duration of treatment and the physiologic needs of the diseased cornea. Bullous keratopathy, recurrent epithelial erosion syndrome, dry eye and postoperative epithelial defects are amongst their indications. Therapeutic contact lenses should not be indicated in the presence of active infectious keratitis or when the patient is not compliant. Corneal neovascularization, giant papillary conjunctivitis and infectious keratitis are serious complications, which can be prevented by correctly fitting and maintaining the therapeutic contact lenses. Silicon-hydrogel therapeutic contact lenses, due to their higher oxygen permeability, allow extended wear schedules, decreasing the need for frequent lens replacement.

Transplante autólogo de conjuntiva com uso de cola de fibrina em pterígios primários / Conjunctival autologous transplantation using fibrin glue in primary pterygium

OBJETIVO: Avaliar a taxa de recidiva e complicações pós-operatórias em transplante autólogo de conjuntiva com uso de cola de fibrina para adesão do enxerto conjuntival em pterígios primários. Secundariamente, comparar os resultados obtidos aos de um grupo submetido à mesma técnica cirúrgica, com uso de suturas. MÉTODOS: Foram incluídos prospectivamente 106 olhos de 100 pacientes operados de pterígio com uso de cola de fibrina e retrospectivamente 58 olhos de 51 pacientes operados com uso de suturas. Avaliaram-se: idade, localização, grau e invasão do pterígio e complicações pós-operatórias. Os pacientes foram acompanhados por um período mínimo de cinco meses. RESULTADOS: Dentre os 106 olhos operados com uso de cola, 12 (11,3 por cento) apresentaram recidiva, sendo 4 (3,8 por cento) conjuntivais e 8 (7,5 por cento) corneanas. Entre os fatores estudados, somente a idade foi estatisticamente inferior nos casos recidivados (média de 34,6 vs. 43,7; P=0,033). O tempo até a recidiva variou de 1,6 a 13,1 meses (média de 4,4). Dentre as recidivas corneanas, dois olhos apresentaram invasão além do limbo de até 0,5 mm e seis olhos de 0,6 a 1,0 mm. Nenhum olho foi submetido a reoperação. Outras complicações incluíram: formação de granuloma transitório em três casos; descolamento parcial ou retração do enxerto em três; e "dellen" em um. Dentre os 58 olhos operados com suturas, 15 (25,9 por cento) apresentaram recidiva, sendo 8 conjuntivais (13,8 por cento) e 7 corneanas (12,1 por cento). O tempo até a recidiva variou de 0,7 a 9,7 meses (média de 4,5). Um caso de recidiva corneana foi reoperado com transplante de membrana amniótica. A taxa de recidiva conjuntival foi estatisticamente inferior nos casos em que se utilizou cola do que naqueles com sutura (P=0,023), porém não se observou esta diferença em relação à recidiva corneana (P=0,232). CONCLUSÃO: O uso da cola de fibrina, como método alternativo à sutura, traz bons resultados cirúrgicos e pequena incidência de complicações. Apesar de resultar em menor taxa de recidiva conjuntival, esta técnica não parece diminuir significativamente a incidência de recidiva corneana.

PURPOSE: To assess the rate of recurrence and complications after primary pterygium removal with conjunctival autograft using fibrin tissue adhesive. Secondarily, to compare these results with a retrospective series that underwent the same surgery using sutures. METHODS: A hundred and six eyes of 100 patients who underwent surgery with fibrin glue were prospectively studied, while 58 eyes of 51 patients who underwent surgery with sutures were retrospectively evaluated. Data included: age, gender, eye involved, location, grade and pterygium invasion and post-operative complications. Patients were followed for at least 5 months. RESULTS: Among 106 eyes undergoing surgery with fibrin glue, 12 (11.3 percent) had recurrence, including 4 (3.8 percent) conjunctival and 8 (7.5 percent) corneal. Mean age was statistically inferior in the recurrence cases compared to others (mean of 34.6 vs. 43.7; P=0.033). The time for recurrence ranged from 1.6 to 13.1 months (mean of 4.4). Among the corneal recurrences, 2 eyes had invasion beyond the limbus of up to 0.5 mm and 6 eyes from 0.6 to 1.0 mm. No eye underwent reoperation. Other complications included: transitory granuloma formation in 3 cases, partial graft detachment or slippage in 3 and dellen in 1. In the suture group, 15 eyes (25.9 percent) had recurrence, including 8 conjunctival (13.8 percent) and 7 (12.1 percent) corneal. The time for recurrence ranged from 0.7 to 9.7 months (mean 4.5 months). The conjunctival recurrence rate was statistically inferior in the glue group compared to the suture (P=0.023), however no statistically significant difference was observed in relation to corneal recurrence (P=0.232). CONCLUSION: The use of fibrin glue as an alternative to sutures in pterygium surgery was associated with good results and few complications. Despite a decrease in conjunctival recurrence rates, this technique does not appear to significantly decrease corneal recurrences.

Prognostic factors in open globe injuries.

PURPOSES: To evaluate the main factors related to visual outcome after open globe injuries (excluding intraocular foreign bodies). METHODS: Retrospective study analyzing consecutive ocular lacerations, primarily repaired in this institution, between January 1993 and January 2000. Of the 364 cases, 283 (77.75%) lacerations were statistically analyzed, correlating the preoperative variables with the postoperative visual acuity (VA). Excluded from this study were all patients with less than 6 months of follow-up, previous ocular surgery, unreliable information on VA, intraocular foreign bodies and endophthalmitis. When a bilateral injury was detected, only 1 eye was randomly chosen. RESULTS: It was observed, after statistical analysis (multivariate analysis), that the most important factors related to postoperative poor VA (less than 20/100) were: the length of the laceration, the elapsed time between the injury and the surgery and the presence or absence of vitreous loss, cataract (lens damage), hyphema, laceration posterior to rectus muscle insertion and retinal detachment. CONCLUSION: With this study, it was possible to point out the most important factors related to visual prognosis in open globe injuries. The results found are similar to results previously reported.