Shuwen Lu,1 Haoyu Li,2,3 Xirui Yang,1 Chao Ma,4 Xian Li5 

1Department of Ophthalmology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, People’s Republic of China; 2Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 3Hunan Clinical Research Centre of Ophthalmic Disease, Changsha, Hunan, People’s Republic of China; 4Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 5School of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK

Correspondence: Shuwen Lu, Department of Ophthalmology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, 450052, People’s Republic of China, Email lushuwen9900@163.com Haoyu Li, Hunan Clinical Research Centre of Ophthalmic Disease, No. 139, Renmin Road Central, Changsha, 410011, People’s Republic of China, Email med.dr.lihy@gmail.com

Background: Ocular trauma is a visually and economically devastating cause of visual loss. This study investigated the prevalence and clinical characteristics of ocular trauma in central and northern China, and assessed prognostic factors.
Methods: Cases of ocular trauma that underwent surgical treatment in a tertiary hospital in China between January 1, 2012, and December 31, 2023, were reviewed. All patient data were collected, including demographic information, type of injury, cause of injury, overall condition, number of surgeries, structural damage, surgical complications, and initial and final visual acuity (VA). We constructed three models to explore the prognostic factors of final VA: linear regression, regression tree, and random forest.
Results: Over 12 years, 1019 patients (1019 eyes) with ocular trauma underwent surgery, of which 836 were open globe injuries. Patients were predominantly male (80.8%), with an average age of 31.1 years. The most at-risk age group was 41– 50 years old. Farmers (33.3%) and students (20.9%) were the most common occupations. The most frequent complication was vitreous hemorrhage (95.7%). Most patients required three surgeries (42.2%). During vitrectomy, proliferative vitreoretinopathy and elevated intraocular pressure were observed in 735 patients (72.1%). The final VA ranged from 0 to 3.00 logMAR with a mean of 1.10± 0.43 logMAR. Among the three models, the random forest performed the best. Ocular structural damage and surgical complications, along with the number of surgeries, were important factors affecting the visual prognosis.
Conclusion: Individuals at high risk should be given extra care, as traumatic and surgical complications are the main prognostic factors.

Keywords: eye injuries, visual acuity, prognosis, predictive learning models