Alexandrakis G, Davis J L
Bascom Palmer Eye Institute, University of Miami School of Medicine, FL 33136, USA.
Ophthalmic Surg Lasers. 2000 Jan-Feb;31(1):61-3.
The authors report a case of double-penetrating injury of the globe with intracranial involvement from a pellet gun. A 16-year-old boy had a visual acuity of bare light perception in the left eye after being hit by a pellet. There was an inferior limbal entry site, dense hyphema, and no view of the fundus. Computed tomographic scan showed the pellet intracranially close to the left cavernous sinus. After neurosurgical clearance, the patient underwent primary closure of the corneoscleral entry site followed 3 weeks later by pars plana vitrectomy, lensectomy, and repair of a rhegmatogenous retinal detachment. At 12 months postoperatively, visual acuity was 20/300 and the retina was attached. Our case demonstrates the potential for significant visual recovery in some patients with a penetrating orbital injury and intracranial involvement. Complete radiographic evaluation with neurosurgical consultation is important in the management of these patients prior to ophthalmologic intervention with possible foreign body removal. There is a need for more public awareness regarding the potentially harmful effects of pellet guns.
作者报告了一例气枪造成的眼球双穿透伤并累及颅内的病例。一名16岁男孩被气枪子弹击中后，左眼视力仅为光感。存在下方角膜缘入口处、浓密的前房积血，且无法看清眼底。计算机断层扫描显示子弹位于颅内靠近左侧海绵窦处。在神经外科清除术后，患者首先进行了角膜巩膜入口处的一期缝合，3周后进行了玻璃体切除术、晶状体切除术以及视网膜脱离复位术。术后12个月时，视力为20/300，视网膜复位。我们的病例表明，一些穿透性眼眶损伤并累及颅内的患者有显著视力恢复的可能。在进行可能的异物取出的眼科干预之前，进行全面的影像学评估并咨询神经外科医生对这些患者的管理很重要。需要提高公众对气枪潜在危害的认识。
