Jonas J B, Knorr H L, Budde W M
Department of Ophthalmology and Eye Hospital, University Erlangen-Nürnberg, Germany.
Ophthalmology. 2000 May;107(5):823-8. doi: 10.1016/s0161-6420(00)00079-8.
To evaluate prognostic factors associated with final visual outcome, development of posttraumatic infectious endophthalmitis, and occurrence of proliferative vitreoretinopathy in patients with penetrating ocular injuries caused by intraocular or retrobulbar foreign bodies (FBs).
Clinic-based cross-sectional study.
One hundred thirty patients presenting with penetrating ocular injuries caused by lacerations from FBs were operated on by one of two surgeons between 1989 and 1997. Follow-up time was an average of 20.84 +/- 20.76 months (median: 17.0 months). All FBs were located posterior to the lens.
Pars plana vitrectomy; foreign body removal; additional surgical procedures according to the clinical situation.
Postoperative visual acuity; posttraumatic infectious endophthalmitis; proliferative vitreoretinopathy.
Occurrence of posttraumatic infectious endophthalmitis developing in seven patients (7/130 = 5.4%) was significantly (P = 0.026) associated with removal of the FB later than 24 hours after the accident and with the type of the FB (P < 0.01). Size (P = 0.37) of the FB, preoperative visual acuity (P = 0.62), presence of traumatic cataract (P = 0.75) or a retinal lesion by the FB (P = 0.16), age (P = 0.39), and gender (P = 0.46) did not show a statistically significant influence on the occurrence of endophthalmitis. Statistically significant risk factors for the development of proliferative vitreoretinopathy occurring in 27 patients (27 of 99 [27.6%] patients with a minimal follow-up of 3 months) were size of the FB (P < 0.001), preoperative visual acuity (P = 0.02), presence of a retinal lesion (P = 0.002), and traumatic cataract (P = 0.03). The time between FB removal and the accident was statistically marginally associated with the development of proliferative vitreoretinopathy (P = 0.07). Postoperative visual acuity depended significantly on size of the FB (P = 0.002), preoperative visual acuity (P < 0.001), presence of a retinal lesion (P = 0.049), and location of the retinal lesion (P < 0.001). Three eyes had to be enucleated because of endophthalmitis or phthisis bulbi.
Prognosis in open-globe injuries with intraocular or retrobulbar foreign bodies depends on the size and type of the foreign body, presence and location of retinal lacerations, additional involvement of other intraocular structures, preoperative visual acuity, and timing of surgery. These factors may be important in preoperative counseling of the patient and for planning surgery.
评估眼内或球后异物（FB）导致的穿透性眼外伤患者最终视力预后、创伤后感染性眼内炎的发生以及增殖性玻璃体视网膜病变的相关预后因素。
基于临床的横断面研究。
1989年至1997年间，由两位外科医生之一为130例因FB撕裂伤导致穿透性眼外伤的患者进行手术。随访时间平均为20.84±20.76个月（中位数：17.0个月）。所有FB均位于晶状体后方。
经平坦部玻璃体切除术；取出异物；根据临床情况进行其他手术操作。
术后视力；创伤后感染性眼内炎；增殖性玻璃体视网膜病变。
7例患者（7/130 = 5.4%）发生创伤后感染性眼内炎，与事故后24小时后取出FB以及FB类型显著相关（P = 0.026）（P < 0.01）。FB大小（P = 0.37）、术前视力（P = 0.62）、创伤性白内障的存在（P = 0.75）或FB导致的视网膜病变（P = 0.16）、年龄（P = 0.39）和性别（P = 0.46）对眼内炎的发生未显示出统计学上的显著影响。27例患者（99例中27例[27.6%]，最短随访3个月）发生增殖性玻璃体视网膜病变的统计学显著危险因素为FB大小（P < 0.001）、术前视力（P = 0.02）、视网膜病变的存在（P = 0.002）和创伤性白内障（P = 0.03）。FB取出与事故之间的时间与增殖性玻璃体视网膜病变的发生在统计学上有边缘关联（P = 0.07）。术后视力显著取决于FB大小（P = 0.002）、术前视力（P < 0.001）、视网膜病变的存在（P = 0.049）和视网膜病变的位置（P < 0.001）。3只眼因眼内炎或眼球痨而不得不摘除。
眼内或球后异物导致的开放性眼球损伤的预后取决于异物的大小和类型、视网膜裂伤的存在和位置、其他眼内结构的额外受累情况、术前视力以及手术时机。这些因素在患者术前咨询和手术规划中可能很重要。
