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伴有眼后段眼内异物的穿透性眼外伤的预后

Prognosis of penetrating eye injuries with posterior segment intraocular foreign body.

作者信息

Szijártó Zsuzsanna, Gaál Valéria, Kovács Bálint, Kuhn Ferenc

机构信息

Department of Ophthalmology, Faculty of Medicine, University of Pécs, Ifjúság st. 13, 7624, Pécs, Hungary.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2008 Jan;246(1):161-5. doi: 10.1007/s00417-007-0650-1. Epub 2007 Aug 4.

Abstract

PURPOSE

To identify the prognostic factors concerning the anatomy and visual acuity of eyes subject to trauma related posterior intraocular foreign body.

PATIENTS AND METHODS

The records of 28 eyes of 27 patients who underwent pars plana vitrectomy and intraocular foreign body removal during a 5 year period were retrospectively reviewed. Ocular trauma score was calculated for each eye.

RESULTS

The most common initial findings were corneal wound (68%), lens injury (50%), retinal lesion (50%), vitreous hemorrhage (25%), and endophthalmitis (14%). Multiple foreign body causing perforating injury with retained posterior segment foreign body occurred in 7% of the cases. The foreign body was found on the surface of the retina in 39% of the cases. Postoperative complications were retinal detachment (46%), proliferative vitreoretinopathy (25%), and phthysis (4%). No eye was enucleated and 1 eye (4%) lost light perception. The final best corrected visual acuity became better or equal to 0.5 Snellen E in 34% of the eyes. The mean follow-up was 19 months (1.5-60 months).

CONCLUSIONS

Prognosis was significantly worse in cases with lower trauma score, initial visual acuity less than 0.1 Snellen E, large foreign body, upset of bacterial endophthalmitis, and with proliferative vitreo-retinopathy. Visual outcomes in our cases were better than estimated follow-up visual acuity based on ocular trauma score parameters.

摘要

目的

确定与外伤性眼内后段异物相关的眼部解剖结构和视力的预后因素。

患者与方法

回顾性分析27例患者28只眼在5年期间接受玻璃体切割术和眼内异物取出术的记录。计算每只眼的眼外伤评分。

结果

最常见的初始表现为角膜伤口(68%)、晶状体损伤(50%)、视网膜病变(50%)、玻璃体出血(25%)和眼内炎(14%)。7%的病例存在多个异物导致穿孔伤并伴有后段异物残留。39%的病例异物位于视网膜表面。术后并发症包括视网膜脱离(46%)、增殖性玻璃体视网膜病变(25%)和眼球痨(4%)。无一例眼球摘除,1只眼(4%)丧失光感。最终最佳矫正视力在34%的眼中提高或等于0.5 Snellen E。平均随访时间为19个月(1.5 - 60个月)。

结论

外伤评分较低、初始视力低于0.1 Snellen E、异物较大、细菌性眼内炎发作以及增殖性玻璃体视网膜病变的病例预后明显较差。我们病例的视觉结果优于基于眼外伤评分参数估计的随访视力。

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