Alfaro D V, Tran V T, Runyan T, Chong L P, Ryan S J, Liggett P E
Department of Ophthalmology, University of Southern California School of Medicine.
Am J Ophthalmol. 1992 Jul 15;114(1):81-5. doi: 10.1016/s0002-9394(14)77416-1.
Pars plana vitrectomy and scleral buckling were performed on 22 eyes of 19 patients for treatment of perforating eye injuries from shotgun pellets. We reviewed the intraoperative findings at the time of vitrectomy to determine what factors might influence final visual acuity. The presence of a total retinal detachment at vitrectomy portended a poor prognosis when compared with eyes without total retinal detachment, as only one of ten eyes with total retinal detachment obtained useful vision (P = .002). Preoperative separation of the posterior vitreous was associated with a favorable outcome when compared with the absence of posterior vitreous detachment (P = .035), as ten of 16 eyes with posterior vitreous detachment at the time of vitrectomy ultimately achieved functional vision. The locations of the exit wounds did not affect visual success in the overall series of patients. However, in the patients who achieved visual success, exit wounds outside the vascular arcades were more likely to be associated with final visual acuities of, or better than, 20/70 than were those within the arcades (P = .022). Other prognostic factors, such as the number of perforations and the use of cryotherapy, were also examined for their effects on final visual outcome. However, these factors did not appear to affect visual outcome statistically.
对19例患者的22只眼进行了玻璃体切除术和平坦部巩膜扣带术，以治疗霰弹所致的眼球穿孔伤。我们回顾了玻璃体切除术时的术中发现，以确定哪些因素可能影响最终视力。与无完全性视网膜脱离的眼相比，玻璃体切除术时存在完全性视网膜脱离预示预后不良，因为10只完全性视网膜脱离的眼中只有1只获得了有用视力（P = 0.002）。与无玻璃体后脱离相比，术前玻璃体后脱离与较好的预后相关（P = 0.035），因为玻璃体切除术时16只有玻璃体后脱离的眼中有10只最终获得了功能性视力。在整个患者系列中，伤口出口位置不影响视力恢复。然而，在视力恢复的患者中，血管弓外的伤口出口比血管弓内的伤口出口更有可能与最终视力达到或优于20/70相关（P = 0.022）。还研究了其他预后因素，如穿孔数量和冷冻疗法的使用对最终视力结果的影响。然而，这些因素似乎在统计学上不影响视力结果。
