Soliman Mahmoud M, Macky Tamer A
Department of Ophthalmology, Kasr El Aini Hospital, Cairo University, El-Manial, Cairo, Egypt.
Graefes Arch Clin Exp Ophthalmol. 2008 Feb;246(2):205-12. doi: 10.1007/s00417-007-0720-4. Epub 2007 Dec 11.
To review the epidemiology of serious ocular trauma presenting to Kasr El Aini Hospital, Cairo University.
This is a prospective epidemiological and clinical study of ocular trauma patients admitted to Kasr El Aini hospital during a 6-month period; January-June 2000. Cases were analyzed with respect to: (1) demographics, (2) time, place and nature of trauma, (3) type of injury, (4) time to receive care, and (5) management and visual outcomes following primary repair.
One hundred and fifty three eyes of 147 patients (six bilateral injuries) sustaining serious ocular injury requiring hospitalization were included during the study period. Eighty percent of ocular trauma occurred in men (P < 0.001 chi-square test) with an average age of 22 years (ranging from 2 months to 76 years). There were 123 (80.4%) open globe injuries and 30 (19.6%) closed globe injuries. Of the open globe injuries, 48 eyes (31.4% of all eyes) were ruptured globes and 75 eyes (49% of all eyes) were lacerated globes (37 intraocular foreign bodies, 35 penetrating injuries and three perforating injuries, that is 24%, 23%, and 2% respectively of all injured eyes). Of the closed globe injuries, 5.9% had hyphema (33% of all patients), 4% lamellar lacerations, and 2.5% vitreous hemorrhage with retinal detachment. Most of the injuries occurred (39.5%) and presented (36.7%) between 12:00-5:59 PM: . Eighteen patients (12%) presented after 24 hours, and nine patients (6%) 1 week after the time of trauma. Presenting visual acuity in 123 patients (123 eyes) was as follows: 98 (80%), ten (8%) and 15 (12%) patients had poor, moderate and good visual acuity respectively. Ten eyes developed posttraumatic endophthalmitis (8% of open globe injuries). On leaving the hospital, 77.1% eyes had a visual acuity of less then 1/60 (poor), 3.9% were between 1/60 and 6/60 (moderate), and 19% were 6/36 and/or better (good). Fifty-two (35%) patients were lost in follow-up: at 1 month, 60%, 7% and 33% of the rest had poor, moderate and good visual acuity respectively.
The majority of ocular trauma in our population was due to assaultive injuries occurring mainly in males. Open globe injuries were more common than closed globe injuries, and globe lacerations were more common than ruptured globes. Open globe injuries, especially ruptured globes, had the worst visual outcomes. The initial visual acuity correlated well with the final visual acuity. Immediate and comprehensive medical care is mandatory for ocular trauma patients. Educating the public is essential if we wish to prevent eye injuries.
回顾开罗大学卡斯尔·艾尼医院收治的严重眼外伤的流行病学情况。
这是一项对2000年1月至6月期间在卡斯尔·艾尼医院住院的眼外伤患者进行的前瞻性流行病学和临床研究。对病例进行了以下方面的分析：（1）人口统计学特征，（2）创伤的时间、地点和性质，（3）损伤类型，（4）接受治疗的时间，以及（5）一期修复后的处理和视力预后。
研究期间纳入了147例（6例双侧损伤）因严重眼外伤需要住院治疗的患者的153只眼。80%的眼外伤发生在男性患者中（卡方检验，P<0.001），平均年龄为22岁（范围从2个月至76岁）。开放性眼球损伤123例（80.4%），闭合性眼球损伤30例（19.6%）。在开放性眼球损伤中，48只眼（占所有眼的31.4%）为眼球破裂，75只眼（占所有眼的49%）为眼球裂伤（37例眼内异物、35例穿透伤和3例穿孔伤，分别占所有受伤眼的24%、23%和2%）。在闭合性眼球损伤中，5.9%有前房积血（占所有患者的33%），4%有板层裂伤，2.5%有玻璃体积血伴视网膜脱离。大多数损伤（39.5%）发生在下午12:00至5:59之间，就诊时间也多在这个时间段（36.7%）。18例患者（12%）在受伤24小时后就诊，9例患者（6%）在受伤1周后就诊。123例患者（123只眼）就诊时的视力情况如下：98例（80%）视力差，10例（8%）视力中等，15例（12%）视力良好。10只眼发生了外伤性眼内炎（占开放性眼球损伤的8%）。出院时，77.1%的眼视力小于1/60（差），3.9%的眼视力在1/60至6/60之间（中等），19%的眼视力为6/36及以上（良好）。52例（35%）患者失访：在1个月时，其余患者中60%视力差，7%视力中等，33%视力良好。
我们研究人群中的大多数眼外伤是由于攻击性损伤导致的，主要发生在男性。开放性眼球损伤比闭合性眼球损伤更常见，眼球裂伤比眼球破裂更常见。开放性眼球损伤，尤其是眼球破裂，视力预后最差。初始视力与最终视力密切相关。眼外伤患者必须立即接受全面的医疗护理。如果我们希望预防眼外伤，对公众进行教育至关重要。
