Traumatic Retinal Detachment: A Comparative Study in Closed and Open Globe Injuries

Purpose: To investigate the clinical characteristics and prognosis of patients with traumatic retinal detachment (TrRD) based on the mechanism of ocular injury and identify prognostic factors associated with clinical outcomes. We hypothesized that open globe injuries would demonstrate worse clinical presentations and poorer functional outcomes compared to closed globe injuries. Methods: This retrospective study included 98 eyes of 98 patients diagnosed with TrRD who underwent surgery, followed by a minimum of 6 months of postoperative observation. The eyes were categorized into two groups based on the mechanism of ocular injury: closed and open injuries. The clinical presentations and postoperative outcomes of the two groups were evaluated, and factors associated with anatomical and functional success were identified. Results: Of the 98 eyes, 37 (37.8%) were classified as closed injury group and 61 (62.2%) as open injury group. Patients in the open group were more likely to exhibit vitreous hemorrhage (p = 0.003), subretinal hemorrhage (p = 0.003), and retinal incarceration than those in the closed group. Although there was no difference in the anatomical outcomes between the two groups, significantly more patients achieved functional success in the closed group than those in the open group (45.9% vs. 24.6%, p = 0.043). Anatomical success was associated with the absence of giant retinal tears, retinal incarceration, and proliferative vitreoretinopathy (≥grade B). Functional success was significantly associated with better baseline best-corrected visual acuity, intraoperative intraocular lens implantation, and no retinectomy during surgery. Conclusions: Despite the clinical presentation variations among patients with TrRD with closed and open injuries, there were no differences in anatomical outcomes between the two groups. Patients in the open group had poorer functional outcomes. By identifying specific prognostic factors associated with anatomical and functional success, this study provides evidence-based guidance for management and prognostication of patients with TrRD.