Clinical and radiological factors in traumatic open-globe injuries operated via primary enucleation, evisceration versus primary repair in Somalia

Traumatic eye injuries are an important cause of visual impairment and can significantly affect patients’ quality of life. Accounting for approximately 7% of all bodily injuries and 10–15% of ocular diseases, traumatic eye injuries pose a substantial medical and socioeconomic burden. This study aimed to evaluate the clinical and radiological characteristics of traumatic open-globe injuries (OGIs) that resulted in either primary enucleation/evisceration or primary repair at a tertiary hospital in Mogadishu, Somalia. This retrospective study was conducted at Mogadishu Somalia Turkey Training and Research Hospital and included 52 eyes of 51 patients treated for traumatic OGIs between January 2020 and June 2022. Twenty-four eyes underwent primary enucleation/evisceration, while 28 eyes underwent primary repair. Continuous variables were compared using independent sample t-tests, and categorical variables were analyzed with the Pearson Chi-square test. Hierarchical regression analyses were performed to assess the association between surgical approach and selected clinical and radiological parameters. Statistical significance was defined as p < 0.05. Initial regression analysis revealed that initial visual acuity, cause of injury, and concomitant orbital fracture significantly predicted the surgical approach [F(4,44) = 23.440, p < 0.001], accounting for 70.1% of the variability. Initial visual acuity (B = 0.306, p = 0.008), cause of injury (B = 0.269, p = 0.010), and orbital fracture (B=-0.508, p < 0.001) were significant predictors. A second regression model incorporating orbital wall fracture components explained 74.8% of the variability [F(8,40) = 13.600, p < 0.001], with orbital roof fracture (B=-0.343, p = 0.008) emerging as a key factor. Initial visual acuity, cause of injury, and the presence of orbital fractures were significantly associated with the choice of primary surgical approach in traumatic OGIs. In particular, orbital roof fractures were identified as an important radiological factor influencing surgical decision-making.