al-Qurainy I A, Stassen L F, Dutton G N, Moos K F, el-Attar A
Tennent Institute of Ophthalmology, Western Infirmary, Glasgow.
Br J Oral Maxillofac Surg. 1991 Oct;29(5):291-301. doi: 10.1016/0266-4356(91)90114-k.
Ocular injuries commonly occur in patients with facial fractures. This prospective study was set up to determine the incidence of ocular injuries, as assessed by an ophthalmologist, in patients who had sustained midfacial fractures. Over a 2-year period, a study of 363 patients who had sustained midfacial trauma sufficient to lead to a facial bone fracture (438 fractures) was undertaken and patients received a comprehensive examination by an ophthalmologist and an orthoptist within 1 week of injury. The characteristics of the eye injuries sustained were related to the aetiology of the fracture, the type of fracture, and the sex and age of each patient. Ninety percent of patients sustained ocular injuries of various severities. Sixty three percent of patients sustained only minor or transient ocular injuries, 16% suffered moderately severe ocular injury and 12% experienced severe eye injuries. Road traffic accident was associated with the highest incidence of severe ocular disorder (9/45 = 20%) whilst assaults had the second highest incidence at 11% (20/181). One third of all patients with comminuted malar fracture suffered a severe ocular disorder (9/27) whilst blow-out fracture came second at 16.7% (6/36). Fifty six patients (15.4%) had a decrease in their visual acuity and 9 patients (2.5%) had significant traumatic optic neuropathy. Decrease in visual acuity was the main clinical finding accompanying the majority of significant eye injuries. When ocular injuries were related to aetiology, it was apparent that road traffic accidents and assaults associated with alcohol abuse showed the highest incidence of major ocular dysfunction. It is suggested that all patients sustaining midfacial fracture associated with a significant decrease in visual acuity either pre- or postoperatively should have an early ophthalmological review.
眼部损伤常见于面部骨折患者。本前瞻性研究旨在确定由眼科医生评估的中面部骨折患者眼部损伤的发生率。在两年期间，对363例遭受足以导致面骨骨折（438处骨折）的中面部创伤患者进行了研究，患者在受伤后1周内接受了眼科医生和斜视矫正师的全面检查。所遭受的眼损伤特征与骨折的病因、骨折类型以及每位患者的性别和年龄有关。90%的患者遭受了不同严重程度的眼部损伤。63%的患者仅遭受轻微或短暂的眼部损伤，16%遭受中度严重的眼部损伤，12%经历了严重的眼部损伤。道路交通事故与严重眼部疾病的最高发生率相关（9/45 = 20%），而袭击导致的发生率次之，为11%（20/181）。所有粉碎性颧骨骨折患者中有三分之一遭受了严重的眼部疾病（9/27），而爆裂性骨折次之，为16.7%（6/36）。56例患者（15.4%）视力下降，9例患者（2.5%）患有严重的创伤性视神经病变。视力下降是大多数严重眼部损伤伴随的主要临床发现。当眼部损伤与病因相关时，很明显与酗酒相关的道路交通事故和袭击导致的主要眼部功能障碍发生率最高。建议所有术前或术后视力明显下降的中面部骨折患者应尽早接受眼科复查。
