Evidence map›Paper›PMID 41826731›Full record

SynthesisEye (London, England)2026

Management of traumatic corneal wounds that do not seal after primary closure: a systematic review.

Ben Smith, Trystan MacDonald, Scott F McClellan, Grant A Justin, Rupesh Agrawal, Annette K Hoskin, Kara Cavuoto, James Leong, Andrés Rousselot Ascarza, Fasika A Woreta and 13 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Eye (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Ben SmithNeuroscience and Ophthalmology, School of Infection, Inflammation and Immunology, University of Birmingham, Birmingham, UK.ORCID http://orcid.org/0000-0002-7711-3834
Trystan MacDonaldNeuroscience and Ophthalmology, School of Infection, Inflammation and Immunology, University of Birmingham, Birmingham, UK.
Scott F McClellanVision Centre of Excellence, Research & Development Directorate (J-9), Defence Health Agency, Silver Spring, MD, USA.
Grant A JustinUniformed Services University of the Health Sciences, Bethesda, MD, USA.ORCID http://orcid.org/0000-0001-6084-6399
Rupesh AgrawalNational Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore.ORCID http://orcid.org/0000-0002-6662-5850
Annette K HoskinSave Sight Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.ORCID http://orcid.org/0000-0002-7732-0323
Kara CavuotoBascom Palmer Eye Institute, University of Miami, Miami, FL, USA.
James LeongSydney Eye Hospital, Sydney, NSW, Australia.
Andrés Rousselot AscarzaConsultorios Oftalmológicos Benisek-Ascarza, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.ORCID http://orcid.org/0000-0003-2341-0988
Fasika A WoretaUniformed Services University of the Health Sciences, Bethesda, MD, USA.ORCID http://orcid.org/0000-0001-9401-4283
Kyle E MillerUniformed Services University of the Health Sciences, Bethesda, MD, USA.ORCID http://orcid.org/0000-0002-3193-7926
William G GensheimerWhite River Junction Veterans Administration Medical Center, White River Junction, Hartford, VT, USA.
Tom H WilliamsonDepartment of Engineering and Biological Sciences, University of Surrey, Surrey, UK.ORCID http://orcid.org/0000-0002-1879-449X
Felipe Dhawahir-ScalaManchester Royal Eye Hospital, Manchester, UK.
Peter ShahOphthalmology Department, University Hospitals Birmingham National Health Service Foundation Trust, Birmingham, UK.
Gangadhara SundarDepartment of Ophthalmology, National University Hospital, Singapore, Singapore.
Robert A MazzoliUniformed Services University of the Health Sciences, Bethesda, MD, USA.ORCID http://orcid.org/0000-0003-4418-5062
Ferenc KuhnHelen Keller Foundation for Research and Education, Birmingham, AL, USA.ORCID http://orcid.org/0000-0001-9085-4875
Malcolm WoodcockWorcestershire Acute Hospitals NHS Trust, Worcester, UK.
Stephanie L WatsonSave Sight Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.ORCID http://orcid.org/0000-0001-6699-1765
Marcus ColyerUniformed Services University of the Health Sciences, Bethesda, MD, USA.
Renata Sm GomesNorthern Hub for Veterans and Military Families Research, Northumbria University, Newcastle, UK.
Richard J BlanchNeuroscience and Ophthalmology, School of Infection, Inflammation and Immunology, University of Birmingham, Birmingham, UK. r.j.blanch@bham.ac.uk.ORCID http://orcid.org/0000-0002-6142-3280

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeOpen globe injury (OGI) may be associated with corneal wounds that are challenging to close, with a reported wound leakage rate of up to 16%. Management options include conservative and surgical options. No consensus exists on optimal management and studies addressing this have not previously been reviewed.

methodsWe conducted a systematic review to identify all studies including adult patients after OGI involving the cornea and requiring secondary closure after primary repair. All studies reporting secondary closure methods and outcomes were reported. Data were combined in a narrative synthesis and methodological quality assessed using Joanna-Briggs critical appraisal tools.

resultsFifty-eight eyes from seven retrospective studies and one prospective study were included. Secondary closure included conservative options of stromal hydration, bandage contact lens, cyanoacrylate glue and aqueous suppressants and surgical management including resuturing, lamellar and full-thickness corneal grafting and scleral autograft with amniotic membrane. One study reported successful conservative management in 26 out of 34 cases (76%) attempted. Re-suturing was successful in 17 out of 20 cases (85%) but required subsequent corneal grafting in three cases. Ten corneal grafts and three scleral autografts with amniotic membrane were successful.

conclusionsConservative approaches may have a high initial success rate, although these findings were based on a single retrospective study. When conservative approaches were unsuitable or unsuccessful, resuturing leaking wounds was successful in most cases, while lamellar and full-thickness corneal grafting and scleral autograft were additional options.

Indexed as

Corneal InjuriesEye Injuries, PenetratingWound Closure TechniquesWound HealingCorneal TransplantationHumans

Identifiers

PMID41826731
PMCPMC13195154

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.