Jules Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA.
Ophthalmic Plast Reconstr Surg. 2012 Jan-Feb;28(1):e17-9. doi: 10.1097/IOP.0b013e318213f5fb.
Globe prolapse into the maxillary sinus after trauma is rare and usually portends a very poor visual prognosis. The authors present an unusual case of late restoration of central vision after such trauma. A 20-year-old man presented after motorcycle injury with a large right floor and medial orbital wall fracture with displacement of the globe into the maxillary sinus. The patient had no light perception on initial exam and was emergently taken to the operating room for globe exploration. No globe rupture was found, and the right orbital floor and medial wall fractures were repaired. Three days of intravenous methylprednisolone at 250 mg every 6 hours was administered postoperatively with no change in visual status, and the patient was discharged home on a rapid oral prednisone taper. At postoperative week 6, vision had returned to 20/20 OD centrally. Visual field testing revealed a central tunnel of vision. The patient's visual function continues to remain stable 2 years after the initial trauma.
外伤后球突出入上颌窦罕见，通常预示着视力预后极差。作者报告了一例此类外伤后迟发性视力恢复的罕见病例。一名 20 岁男性因摩托车事故受伤，右侧眶底和内侧壁骨折，球突出入上颌窦。患者初次检查无光感，急诊送入手术室进行眼球探查。未发现眼球破裂，修复了右侧眶底和内侧壁骨折。术后给予 3 天静脉注射甲基强的松龙 250mg，每 6 小时一次，视力无变化，患者出院后开始快速口服泼尼松减量。术后 6 周，右眼视力恢复至中央 20/20。视野检查显示中心隧道视野。初次外伤后 2 年，患者的视力功能持续稳定。
