Increased risk of sympathetic ophthalmia in ocular surgical patients with trauma history.

PURPOSE: To determine the risk of sympathetic ophthalmia (SO) among ocular surgery patients with and without a history of ocular trauma.

METHODS

This cohort study used the multi-institutional TriNetX platform to enroll ocular surgery patients with and without a history of ocular trauma from January 1, 2005, to December 31, 2023. The primary outcome was the risk of developing SO in the ocular trauma group compared to those without.

RESULTS

A total of 16,198 patients who underwent ocular surgery with prior ocular trauma (mean [SD] age, 45.59 [23.26] years; 28.58% female) and 16,198 without trauma history (46.49 [25.13] years; 28.74% female) were included. Patients with prior trauma had a higher risk of SO, with increased risk evident from 3 months after the index date (HR, 13.45; 95% CI, 1.77-102.20) and persisting through 18 years (7.21; 2.83-18.37). Stratified analyses showed elevated risk after anterior segment surgery (21.62; 2.91-160.40) and vitreoretinal surgery (5.84; 1.31-26.08). Increased risk was also observed for both closed globe injury (21.97; 2.96-163.00) and open globe injury (10.80; 2.54-45.92). Subgroup analysis showed higher SO risk among patients aged 18-39 years (5.70; 1.28-25.48) and 40-64 years (17.71; 2.36-132.60), in both males (12.96; 3.07-54.59) and females (9.10; 1.15-71.82), and among White patients (19.28; 2.58-144.00).

CONCLUSIONS

Our findings suggest that patients who have undergone ocular surgery with histories of ocular trauma should be closely monitored for the development of SO.