George Joshua, Ali Nadir, Rahman Noor Affizan, Joshi Nayan
Ophthalmology Department, RIPAS Hospital, Bandar Seri Begawan, BA1710, Brunei Darussalam.
Int Ophthalmol. 2013 Jun;33(3):277-84. doi: 10.1007/s10792-012-9687-1. Epub 2012 Dec 11.
To review the etiologies, prognostic factors and treatment outcomes of intraocular foreign bodies (IOFBs) occurring in the population of Brunei Darussalam, and provide guidelines to prevent and manage such injuries. A retrospective review was performed for all cases of traumatic IOFBs managed in our centre during a 3-year period between May 2008 and April 2011. The mechanism of injury, management, complications and visual outcomes were analyzed. Majority of the patients were males (93 %) and the mean age was 36 years. The main causes of trauma were metal hammering and grass cutting (43 % each). Other causes include road traffic accidents and firecracker explosion (7 % each). The visual outcome was ≥6/18 in 50 % and 'No perception of light' in 29 %. Causes of poor visual outcome were retinal detachment with proliferative vitreoretinopathy (21 %), endophthalmitis (21 %) and globe maceration (7 %). Prognostic factors associated with significantly worse final visual outcome included posterior location of the IOFB (p = 0.05) and larger IOFB size (p < 0.001). The time from injury to surgery did not correlate with a worse visual prognosis. In Brunei Darussalam, the commonest causes of IOFBs are hammering metal and cutting grass using power tools. The visual outcome varies between 6/6 and NPL. Poor visual outcome is related to the severity of the initial ocular injury, posterior segment IOFB and endophthalmitis.
回顾文莱达鲁萨兰国人群眼内异物(IOFBs)的病因、预后因素及治疗结果,并提供预防和处理此类损伤的指南。对2008年5月至2011年4月期间在我们中心接受治疗的所有外伤性IOFBs病例进行回顾性研究。分析损伤机制、处理方法、并发症及视力结果。大多数患者为男性(93%),平均年龄为36岁。外伤的主要原因是金属锤击和割草(各占43%)。其他原因包括道路交通事故和鞭炮爆炸(各占7%)。视力结果为≥6/18的占50%,“无光感”的占29%。视力预后差的原因是视网膜脱离伴增殖性玻璃体视网膜病变(21%)、眼内炎(21%)和眼球浸软(7%)。与最终视力结果显著较差相关的预后因素包括IOFB的后部位置(p = 0.05)和较大的IOFB尺寸(p < 0.001)。受伤至手术的时间与较差的视力预后无关。在文莱达鲁萨兰国,IOFBs最常见的原因是锤击金属和使用电动工具割草。视力结果在6/6至无光感之间变化。视力预后差与初始眼外伤的严重程度、眼后段IOFB和眼内炎有关。