Weichel Eric D, Colyer Marcus H
Walter Reed Army Medical Center, Washington, District of Columbia 20307, USA.
Curr Opin Ophthalmol. 2008 Nov;19(6):519-25. doi: 10.1097/ICU.0b013e3283140e98.
To review the recent literature regarding combat ocular trauma during hostilities in Operations Iraqi Freedom and Enduring Freedom, describe the classification of combat ocular trauma, and offer strategies that may assist in the management of eye injuries.
Several recent publications have highlighted features of combat ocular trauma from Operation Iraqi Freedom. The most common cause of today's combat ocular injuries is unconventional fragmentary munitions causing significant blast injuries. These explosive munitions cause high rates of concomitant nonocular injuries such as traumatic brain injury, amputation, and other organ injuries. The most frequent ocular injuries include open-globe and adnexal lacerations. The extreme severity of combat-related open-globe injuries leads to high rates of primary enucleation and retained intraocular foreign bodies. Visual outcomes of intraocular foreign body injuries are similar to other series despite delayed removal, and no cases of endophthalmitis have occurred. Despite these advances, however, significant vision loss persists in cases of perforating globe injuries as well as open and closed-globe trauma involving the posterior segment.
This review summarizes the recent literature describing ocular and systemic injuries sustained during Operations Iraqi and Enduring Freedom. An emphasis on classification of ocular injuries as well as a discussion of main outcome measures and complications is discussed.
回顾近期关于伊拉克自由行动和持久自由行动中敌对状态下战斗性眼外伤的文献，描述战斗性眼外伤的分类，并提供有助于眼外伤管理的策略。
近期的几篇出版物强调了伊拉克自由行动中战斗性眼外伤的特征。当今战斗性眼外伤最常见的原因是非常规破片弹药导致严重的爆炸伤。这些爆炸弹药导致大量伴随的非眼部损伤，如创伤性脑损伤、截肢和其他器官损伤。最常见的眼部损伤包括开放性眼球伤和附属器撕裂伤。与战斗相关的开放性眼球伤极其严重，导致眼球摘除率和眼内异物残留率很高。尽管眼内异物伤的取出延迟，但视觉预后与其他系列相似，且未发生眼内炎病例。然而，尽管有这些进展，在眼球穿孔伤以及累及后段的开放性和闭合性眼球外伤病例中，仍存在严重的视力丧失。
本综述总结了近期描述伊拉克自由行动和持久自由行动期间眼部和全身损伤的文献。重点讨论了眼外伤的分类以及主要结局指标和并发症。
