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开放性眼球损伤手术后视力结果的预后因素。

Prognostic factors for vision outcome after surgical repair of open globe injuries.

机构信息

Department of Ophthalmology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore.

出版信息

Indian J Ophthalmol. 2011 Nov-Dec;59(6):465-70. doi: 10.4103/0301-4738.86314.

Abstract

PURPOSE

To evaluate the factors influencing final visual outcome after surgical repair of open globe injuries.

MATERIALS AND METHODS

The study was carried out at a tertiary referral eye care center in Central India. In this retrospective study, case records of 669 patients with open globe injuries were analyzed. Different preoperative variables were correlated with the final visual outcome. Exclusion criteria were patients with less than four months follow up, previous ocular surgery, presence of intraocular foreign body or endophthalmitis at the time of presentation. Using statistical tests, the prognostic factors for vision outcome following surgical repair of open globe injuries were studied.

RESULTS

Based on the Spearman's Rho correlation analysis, following factors were found to be significantly associated with the final visual acuity at univariate level: age (P<0.001), preoperative visual acuity (P=0.045), mode of injury (P=0.001), and time lag between the injury and surgery (P=0.003). None of the other clinical factors have statistically significant correlation with final visual acuity. On multivariate analysis using binary logistic regression, only age, mode of injury and the time lag between injury and surgery achieved statistically significant results.

CONCLUSION

In the current study, elapsed time between the injury and surgery, age of the patient, preoperative visual acuity and mode of injury were found to be adversely affecting the final visual outcome. Recognizing these factors prior to surgical intervention or intraoperatively can help the surgeon in evidence-based counseling of the trauma victim and family.

摘要

目的

评估影响开放性眼球损伤手术修复后最终视力结果的因素。

材料与方法

本研究在印度中部的一家三级转诊眼科中心进行。在这项回顾性研究中,分析了 669 例开放性眼球损伤患者的病历。将不同的术前变量与最终视力结果相关联。排除标准为随访时间少于 4 个月、先前眼部手术、就诊时存在眼内异物或眼内炎的患者。使用统计检验研究了开放性眼球损伤手术后视力结果的预后因素。

结果

基于 Spearman's Rho 相关分析,以下因素在单变量水平上与最终视力显著相关:年龄(P<0.001)、术前视力(P=0.045)、损伤方式(P=0.001)和损伤与手术之间的时间延迟(P=0.003)。其他临床因素与最终视力均无统计学相关性。使用二元逻辑回归进行多变量分析时,只有年龄、损伤方式和损伤与手术之间的时间延迟具有统计学意义。

结论

在本研究中,受伤与手术之间的时间延迟、患者年龄、术前视力和损伤方式均对最终视力结果产生不利影响。在手术干预前或手术过程中识别这些因素可以帮助外科医生对创伤受害者及其家属进行基于证据的咨询。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bfc2/3214417/757b54a15c4d/IJO-59-465-g001.jpg

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