Mellema Peter A, Dewan Mohit A, Lee Michael S, Smith Scott D, Harrison Andrew R
Department of Ophthalmology, University of Minnesota, Minneapolis, Minnesota, MN 55455, USA.
Ophthalmic Plast Reconstr Surg. 2009 Jul-Aug;25(4):306-8. doi: 10.1097/IOP.0b013e3181aa9a73.
To determine the incidence of severe ocular injury in visually asymptomatic patients with orbital fractures.
Retrospective review of 241 cases of orbital fracture, of which 126 cases had ophthalmic evaluation within 1 week of injury and were included in our analysis. Fracture type, associated symptoms, and injuries were evaluated. Injuries were categorized into severe (requiring immediate evaluation), moderate (requiring evaluation within the next several days), and mild (may not require evaluation). The presence of symptoms and associated visual acuity and severity of injury were analyzed for statistical significance.
Forty-six of 126 patients with orbital fractures were visually asymptomatic. Of these patients, none had severe injuries, 15 had moderate injuries, 23 had mild injuries, and 8 had no injuries. Of those with symptoms, 15 had severe injuries, 27 had moderate injuries, 35 had mild injuries, and 3 had no injuries. Using Fisher exact test analysis, asymptomatic patients were unlikely to have severe ocular injury in the setting of orbital fracture (p = 0.0009). In addition, visual acuity did not accurately predict the presence of severe ocular injury.
Visually asymptomatic patients with orbital fractures do not have ocular injury requiring emergent evaluation.
确定视力无症状的眼眶骨折患者中严重眼外伤的发生率。
回顾性分析241例眼眶骨折病例，其中126例在受伤后1周内接受了眼科评估并纳入我们的分析。对骨折类型、相关症状和损伤进行评估。损伤分为严重（需要立即评估）、中度（需要在接下来几天内评估）和轻度（可能不需要评估）。分析症状的存在、相关视力和损伤严重程度的统计学意义。
126例眼眶骨折患者中有46例视力无症状。在这些患者中，无严重损伤，15例为中度损伤，23例为轻度损伤，8例无损伤。有症状的患者中，15例为严重损伤，27例为中度损伤，35例为轻度损伤，3例无损伤。采用Fisher精确检验分析，眼眶骨折情况下无症状患者不太可能发生严重眼外伤（p = 0.0009）。此外，视力不能准确预测严重眼外伤的存在。
视力无症状的眼眶骨折患者没有需要紧急评估的眼外伤。
