Burger Berdine M, Kelty Patrick J, Bowie Esther M
Department of Ophthalmology, Albert Florens Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
J Trauma. 2009 Dec;67(6):1320-2. doi: 10.1097/TA.0b013e3181c3eb83.
Nail-gun accidents have become a common reason for penetrating ocular injuries in patients presenting to the emergency room with globe trauma. To date, there are only five patients (one case report and one small case series) in the medical literature of penetrating ocular injury due to nail-guns. The aim of this study is to describe the epidemiology and visual outcomes of patients presenting to a tertiary medical center with ocular injuries resulting from nail-gun injuries.
This is an institutional review board-approved retrospective chart review of 24 patients presenting to the Medical University of South Carolina after sustaining eye injuries secondary to the use of nail-guns. The records of 178 patients with penetrating eye injuries treated between July 1996 and June 2006 were reviewed. Twenty-four patients (14%) had open globe injuries related to nail-guns. Demographic data, ocular examination findings, and visual outcomes were recorded.
Of the 24 cases identified, 17 were work-related; this represented approximately 71% of patients. All were men with an average age of 29.4 years. Fifty-eight percent of the patients were non-English speaking. There was no record of any patient wearing safety glasses at the time of injury. The visual acuity at presentation ranged from 20/20 to hand motion or worse. Half (50%) of these patients had a presenting visual acuity of hand motion or worse. At last examination, 38% (nine patients) had visual acuity of 20/40 or better, 34% (eight patients) had visual acuity of counting fingers to hand motion, 13% (three patients) 20/60, 4% (one patient) 20/200, and three were lost to follow-up. The correlation coefficient between visual acuity at presentation and most recent was significant at 0.679 (p = 0.001).
The majority of nail-gun injuries presented in this series were work-related. These injuries could be prevented with adherence to established safety measures including proper training and education of nail-gun operators, the use of sequential-trip triggers, and required safety glasses. Visual acuity outcomes of these 24 patients are better than what might be expected due to the nature of the injury.
在因眼球外伤而到急诊室就诊的患者中，射钉枪意外已成为穿透性眼外伤的常见原因。迄今为止，医学文献中仅有5例（1例病例报告和1例小病例系列）因射钉枪导致的穿透性眼外伤患者。本研究的目的是描述在一家三级医疗中心就诊的因射钉枪伤导致眼外伤患者的流行病学情况及视力预后。
这是一项经机构审查委员会批准的回顾性病历审查，研究对象为24例在南卡罗来纳医科大学就诊的、因使用射钉枪而继发眼外伤的患者。回顾了1996年7月至2006年6月期间接受治疗的178例穿透性眼外伤患者的病历。24例患者（14%）有与射钉枪相关的开放性眼球损伤。记录了人口统计学数据、眼部检查结果和视力预后情况。
在确定的24例病例中，17例与工作相关；这约占患者总数的71%。所有患者均为男性，平均年龄29.4岁。58%的患者不会说英语。受伤时没有任何患者佩戴安全眼镜的记录。就诊时的视力范围从20/20到手动或更差。这些患者中有一半（50%）就诊时的视力为手动或更差。在最后一次检查时，38%（9例患者）的视力为20/40或更好，34%（8例患者）的视力为指数到手动，13%（3例患者）为20/60，4%（1例患者）为20/200，3例失访。就诊时视力与最近视力之间的相关系数为0.679，具有显著性（p = 0.001）。
本系列中出现的大多数射钉枪伤与工作相关。遵守既定的安全措施，包括对射钉枪操作人员进行适当培训和教育、使用连续扳机以及要求佩戴安全眼镜，可预防这些损伤。由于损伤的性质，这24例患者的视力预后比预期的要好。
