Department of Ophthalmology, Nikookari Eye Hospital, Tabriz Medical University, Tabriz, Iran.
Retina. 2010 Feb;30(2):294-9. doi: 10.1097/IAE.0b013e3181babd75.
The purpose of this study was to evaluate the anatomical and functional outcomes of surgical intervention in severely traumatized eyes with no light perception (NLP).
In this prospective interventional case series, 18 eyes of 18 patients with severe ocular trauma whose vision was documented as NLP and with relative afferent pupillary defect of 3 to 4+ underwent deep vitrectomy and other appropriate procedures 1 to 3 times.
Vision was NLP in all eyes at the time of surgery, which was performed 3 days to 14 days after the initial trauma. During a mean follow-up period of 20.5 +/- 5.2 months (range, 11-36 months), except for 1 case of phthisis, other eyes achieved acceptable anatomical and functional outcomes. Postoperative vision was NLP in 2 eyes (11.1%), light perception in 3 eyes (16.7%), hand motions in 4 eyes (22.2%), counting fingers in 3 eyes (16.7%), and 20/200 or better in 6 eyes (33.4%).
After eye trauma, NLP vision and relative afferent pupillary defect of 3 to 4+ alone may not be an indication for enucleation. Performing exploratory surgery within 14 days after the injury may salvage the globe and improve vision; this approach also entails positive psychologic effects for patients and relatives.
本研究旨在评估无光感（NLP）严重眼外伤患者手术干预的解剖学和功能结果。
在这项前瞻性干预性病例系列研究中，18 例严重眼外伤患者的 18 只眼视力记录为 NLP，相对传入性瞳孔缺陷为 3 至 4+，在受伤后 1 至 3 天内接受了深部玻璃体切除术和其他适当的手术 1 至 3 次。
所有患者在受伤后 3 天至 14 天内进行手术时，视力均为 NLP，平均随访 20.5 +/- 5.2 个月（范围为 11-36 个月）。除 1 例眼球萎缩外，其他眼均获得可接受的解剖学和功能结果。术后视力 NLP 2 只眼（11.1%）、光感 3 只眼（16.7%）、手动 4 只眼（22.2%）、指数 3 只眼（16.7%）、20/200 或更好 6 只眼（33.4%）。
眼外伤后，NLP 视力和 3 至 4+的相对传入性瞳孔缺陷不一定是眼球摘除的指征。在受伤后 14 天内进行探查性手术可能挽救眼球并改善视力；这种方法还对患者和家属产生积极的心理影响。
