Thevi T, Mimiwati Z, Reddy S C
Department of Ophthalmology, Tengku Ampuan Rahimah Hospital, Klang, Malaysia.
Nepal J Ophthalmol. 2012 Jul-Dec;4(2):263-70. doi: 10.3126/nepjoph.v4i2.6542.
To determine the factors affecting the visual outcome in patients with open globe injuries of eye.
In a prospective interventional study of consecutive patients with open globe injuries, the age, gender, place of injury, object causing injury and safety precautions taken were recorded. A detailed examination of the eye was done with a slit-lamp. X-rays of the orbits were taken in order to determine the presence of a foreign body. The injuries were classified as simple or complicated depending on the involvement of the pupil/iris, lens and retina. Finally, post operative best-corrected visual acuity at last follow up was noted.
Fifty-two patients (52 eyes) were included in the study. The mean age of patients was 27.25±12.62 years (range 9-73 years). The majority of injuries occurred in the workplace (36.5%); nail (15.4%) and glass (15.4%) were the most common objects causing injury. Of those with good initial visual acuity, 90% maintained good visual outcome. Patients with corneal lacerations of less than 5 mm had significant good visual outcome. The number of corneal lacerations and visual axis involvement did not affect the visual outcome. Those with corneoscleral lacerations had significantly poor visual outcomes compared to those with corneal or scleral lacerations alone.
Predictors of good visual outcome are good initial visual acuity, a corneal laceration wound of less than 5mm, a deep anterior chamber, and simple lacerations. Age, gender, place of injury, object causing injury, presence of hyphema or intraocular foreign body, and the use of safety precautions did not affect the visual outcome.
确定影响开放性眼球损伤患者视力预后的因素。
在一项对连续性开放性眼球损伤患者的前瞻性干预研究中，记录患者的年龄、性别、受伤地点、致伤物及采取的安全防护措施。使用裂隙灯对眼睛进行详细检查。拍摄眼眶X线片以确定是否存在异物。根据瞳孔/虹膜、晶状体和视网膜的受累情况将损伤分为单纯性或复杂性。最后，记录末次随访时的术后最佳矫正视力。
52例患者（52只眼）纳入研究。患者的平均年龄为27.25±12.62岁（范围9 - 73岁）。大多数损伤发生在工作场所（36.5%）；钉子（15.4%）和玻璃（15.4%）是最常见的致伤物。初始视力良好的患者中，90%保持了良好的视力预后。角膜裂伤小于5mm的患者视力预后显著良好。角膜裂伤的数量和视轴受累情况不影响视力预后。与单纯角膜或巩膜裂伤患者相比，角巩膜裂伤患者的视力预后显著较差。
良好视力预后的预测因素为初始视力良好、角膜裂伤伤口小于5mm、前房深和单纯裂伤。年龄、性别、受伤地点、致伤物、前房积血或眼内异物的存在以及安全防护措施的使用不影响视力预后。
