To propose a new classification system for open globe injuries (OGIs) and analyse its management outcomes

Background : The BETTS and the OTS are time-tested tools for classifying and prognosticating mechanical ocular injuries. However, anatomical representation of the injuries, status of lens and individual posterior segment structures were not included. Objectives : To propose a new classification system for open globe injuries (OGIs) and analyse its management outcomes Methods : 102 OGI cases undergoing primary repair at a tertiary eye centre were included in this retrospective observational study. Injuries were classified according to the proposed system (zone of injury, presence of traumatic cataract, status of posterior segment and presence of intraocular foreign body (IOFB)) and the visual outcomes were compared. Zone 1 was subdivided in three subzones namely; 1c (central), 1pc (paracentral), and 1p (peripheral). Results : The mean best corrected visual acuity (BCVA) at presentation was 2.81 ± 1.08 and mean final BCVA was 1.75 ± 1.59 (p <0.001). Traumatic cataract was present in 41.2% cases and IOFB in 5.9% cases. The most frequently occurring groups were 1cL0P0FB0 (Zone 1c without traumatic cataract, posterior segment involvement or any IOFB) (7.8%), 1cL1P0FB0 (Zone 1c with traumatic cataract, without posterior segment involvement or any IOFB) (7.8%) and 1pL1P0FB0 (Zone 1p with traumatic cataract, without posterior segment involvement or any IOFB) (7.8%). Posterior segment was involved in 51.9% cases. The comparison between initial and final visual acuities was significant for the zones 1c, 1pc, 1p and 2 (p<0.05), but not for zone 3 (p= 0.1832) Conclusion : The new system provides a holistic approach to OGIs with a better overview of the final visual outcomes.