Pimolrat Weeraya, Choovuthayakorn Janejit, Watanachai Nawat, Patikulsila Direk, Kunavisarut Paradee, Chaikitmongkol Voraporn, Ittipunkul Nimitr
Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Thailand.
Injury. 2014 Jan;45(1):212-6. doi: 10.1016/j.injury.2013.06.003. Epub 2013 Jul 2.
To determine the outcomes and predictive factors of patients with open globe injury requiring pars plana vitrectomy (PPV).
The medical records of 114 patients age 10 years or older who had undergone PPV due to ocular trauma, with at least 6 months follow up, were retrospectively reviewed.
The mean age of the patients was 42 (SD14) years, with males accounting for 89% of the cases. Penetrating eye injury was the most common injury mechanism (43%) with most injuries occurring secondary to work related incidents (54%). After surgical interventions, 78% of the patients had visual improvement of one or more Snellen lines, while no light perception occurred in 10%. Anatomical attachment was achieved in 87% of eyes at the final follow up. Logistic regression analysis showed that the presence of a relative afferent pupillary defect (RAPD) was a significant predictive factor of visual outcome, while initial retinal detachment was a significant predictor of anatomical outcome.
Pupillary reaction is an important presenting ocular sign in estimating the post-vitrectomy poor visual outcome for open globe injury. Vision was restored and improved in more than half of the patients in this study; however, long-term sequelae should be monitored.
确定需要行玻璃体切割术（PPV）的开放性眼球损伤患者的预后及预测因素。
回顾性分析114例年龄10岁及以上因眼外伤接受PPV且随访至少6个月的患者的病历。
患者的平均年龄为42（标准差14）岁，男性占病例的89%。穿透性眼外伤是最常见的损伤机制（43%），大多数损伤继发于与工作相关的事件（54%）。手术干预后，78%的患者视力提高了一个或多个Snellen视力表行数，10%的患者无光感。末次随访时87%的患眼实现了解剖复位。Logistic回归分析显示，相对性传入瞳孔障碍（RAPD）的存在是视力预后的重要预测因素，而初始视网膜脱离是解剖学预后的重要预测因素。
瞳孔反应是评估开放性眼球损伤玻璃体切除术后视力预后不良的重要眼部体征。本研究中超过一半的患者视力得到恢复和改善；然而，应监测长期后遗症。
