Institute of Ophthalmology and Visual Science, New Jersey Medical School, Newark, New Jersey.
Retina. 2014 Feb;34(2):254-61. doi: 10.1097/IAE.0b013e3182979e0b.
To describe the characteristics of nail gun-related open-globe injuries.
Retrospective series of all patients presenting with open globes secondary to nail gun injury from 2000 to 2010. Data were collected on demographics, setting of accident, presenting clinical examination findings, visual acuity, management, surgical procedures needed, and long-term outcomes.
Forty-two patients (43 eyes; mean age, 31.6 years; 100% male; 79% Hispanic) suffered open-globe injury from nail gun accidents. Thirty-seven eyes (86%) sustained injury at work. One of 15 (6.7%) patients, on whom data were available, wore protective eyewear during the incident. Entrance wounds were classified into Zone I (n = 24 [56%]), Zone II (n = 12 [28%]), and Zone III (n = 7 [16%]). Six eyes (14%) had retained intraocular foreign bodies. Mean presenting logarithm of the minimum angle of resolution visual acuity was 1.64 ± 0.83, whereas mean final logarithm of the minimum angle of resolution visual acuity was 1.01 ± 0.96 (P = 0.004). Two eyes (4.7%) had no light perception vision at final examination. Seventeen (40%) patients developed a traumatic cataract, and 2 (4.7%) had dislocated lens fragments. Most common findings on presentation included vitreous hemorrhage (n = 30 [70%]) and hyphema (n = 28 [64%]). Two eyes (4.7%) had a retinal detachment at presentation, and 10 (23%) developed a retinal detachment during follow-up visits. Anatomical success was observed in 11 eyes (92%) with a retinal detachment. Three eyes (7.0%) became phthisical or prephthisical, and 1 was enucleated for severe pain. No eyes developed endophthalmitis or sympathetic ophthalmia.
This is the largest compilation of nail gun-related open-globe injury reported to date. Posterior segment complications, noted in the majority of cases, likely contributed to the overall guarded visual outcomes. Preventative measures for eye protection should be strictly followed while using nail guns.
描述与钉枪相关的开放性眼球损伤的特点。
对 2000 年至 2010 年期间因钉枪伤导致开放性眼球损伤的所有患者进行回顾性系列研究。收集的数据包括人口统计学、事故发生地点、就诊时的临床检查结果、视力、治疗方法、所需的手术程序和长期结果。
42 名患者（43 只眼；平均年龄 31.6 岁；100%为男性；79%为西班牙裔）因钉枪事故导致开放性眼球损伤。37 只眼（86%）在工作中受伤。在可获得数据的 15 名患者中，仅有 1 名（6.7%）在事故中佩戴了防护眼镜。入口伤口分为 3 个区：I 区（24 只眼[56%]）、II 区（12 只眼[28%]）和 III 区（7 只眼[16%]）。6 只眼（14%）有眼内异物残留。就诊时平均最小分辨角对数视力为 1.64 ± 0.83，而平均最终最小分辨角对数视力为 1.01 ± 0.96（P = 0.004）。最终检查时，2 只眼（4.7%）无光感。17 只眼（40%）发生外伤性白内障，2 只眼（4.7%）发生晶状体碎片脱位。就诊时最常见的发现包括玻璃体积血（30 只眼[70%]）和前房积血（28 只眼[64%]）。就诊时，2 只眼（4.7%）发生视网膜脱离，10 只眼（23%）在随访中发生视网膜脱离。视网膜脱离的 11 只眼（92%）解剖复位成功。3 只眼（7.0%）出现眼球萎缩或接近萎缩，1 只眼因严重疼痛而被摘除。无眼发生眼内炎或交感性眼炎。
这是迄今为止报道的最大规模的与钉枪相关的开放性眼球损伤汇编。大多数病例中出现的后段并发症可能导致总体预后不佳。使用钉枪时应严格遵守眼部防护措施。
