Yalcin Tök Ozlem, Tok Levent, Eraslan Elif, Ozkaya Dilek, Ornek Firdevs, Bardak Yavuz
Department of Ophthalmology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey.
J Trauma. 2011 Dec;71(6):1794-800. doi: 10.1097/TA.0b013e31822b46af.
To investigate the factors that influence final visual acuity (VA) in open globe injuries.
The records of patients with open globe injuries who were followed for longer than 6 months between 1998 and 2009 in two different centers were retrospectively reviewed. The data collected included patients' demographics as well as their initial VA, wound location, mechanism and type of injury, clinical findings, and final best-corrected VA. Statistical analysis was conducted using univariate analysis and multiple logistic regression analysis.
Of 313 patients, 73.2% were men, and the mean age was 32.01 years ± 21.04 years. Penetrating injury was the most common type of injury. Of 313 injuries, 212 were caused by sharp/projectile objects, and injuries most commonly occurred in the workplace. In a univariate analysis, the factors contributing to a final VA worse than 20/200 included being older than 50 years, injury in zone 2 or 3, blunt injury, rupture-type injury, poor initial VA, and the presence of endophthalmitis, retinal detachment, relative afferent papillary defect, hyphema, vitreous prolapse, and uveal prolapse. In a multiple logistic regression analysis in which all factors that may influence final VA were analyzed together, poor initial VA, retinal detachment, and vitreous prolapse were found to be statistically significant.
In this retrospective study, the most important factors influencing final VA were initial VA, retinal detachment, and vitreous prolapse, all of which are important with regard to informing the patient of the prognosis and determining the approach the physician will take.
探讨开放性眼球损伤中影响最终视力（VA）的因素。
回顾性分析1998年至2009年期间在两个不同中心随访时间超过6个月的开放性眼球损伤患者的记录。收集的数据包括患者的人口统计学信息以及他们的初始视力、伤口位置、损伤机制和类型、临床发现以及最终最佳矫正视力。采用单因素分析和多元逻辑回归分析进行统计分析。
313例患者中，73.2%为男性，平均年龄为32.01岁±21.04岁。穿透伤是最常见的损伤类型。在313例损伤中，212例由锐器/投射物所致，损伤最常发生在工作场所。单因素分析中，导致最终视力低于20/200的因素包括年龄大于50岁、2区或3区损伤、钝挫伤、破裂型损伤、初始视力差以及存在眼内炎、视网膜脱离、相对性传入性瞳孔障碍、前房积血、玻璃体脱垂和葡萄膜脱垂。在对所有可能影响最终视力的因素进行综合分析的多元逻辑回归分析中，发现初始视力差、视网膜脱离和玻璃体脱垂具有统计学意义。
在这项回顾性研究中，影响最终视力的最重要因素是初始视力、视网膜脱离和玻璃体脱垂，所有这些因素对于告知患者预后以及确定医生将采取的治疗方法都很重要。
