Choovuthayakorn Janejit, Patikulsila Prapatsorn, Patikulsila Direk, Watanachai Nawat, Pimolrat Weeraya
Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Chiang Mai, 50200, Thailand,
Int Ophthalmol. 2014 Aug;34(4):839-44. doi: 10.1007/s10792-013-9890-8. Epub 2013 Dec 22.
To describe the epidemiology, mechanism of injury, and final visual and anatomical outcomes of pediatric patients with open globe injury. The medical records of patients aged ≤ 16 years diagnosed with open globe injury between January 2006 and December 2010 were retrospectively reviewed. Forty-nine pediatric patients were diagnosed with open globe injury during the study period. Forty-one of the 49 patients (83.7 %) were male. The mean age of the patients was 9.3 ± 4.6 years, with 49 % of the injuries occurring in patients between the ages of 11 and 16 years. Ocular penetration was the most common type of injury (63.3 %), occurring most frequently in the cornea (63.3 %). Wooden objects were the most common cause of injury. Following surgical intervention, 40.8 % of the patients obtained a final visual acuity (VA) of ≥ 6/60. Pars plana vitrectomy was performed in 51 % of cases, with only 36 % of these patients having a final VA of ≥ 6/60. The presence of retinal detachment was the only statistically significant factor (odds ratio 0.05, p < 0.001) that affected VA improvement of more than one line. Corneal penetration was frequently observed in pediatric patients with ocular trauma. Pediatric patients with a retinal detachment were significantly more likely to have a poor final visual outcome than open globe patients whose retina remained attached. Despite prompt surgical intervention, useful vision was preserved in less than half of the patients requiring pars plana vitrectomy.
描述小儿开放性眼球损伤患者的流行病学、损伤机制以及最终的视力和解剖学结果。回顾性分析2006年1月至2010年12月期间诊断为开放性眼球损伤的16岁及以下患者的病历。在研究期间,49例小儿患者被诊断为开放性眼球损伤。49例患者中有41例(83.7%)为男性。患者的平均年龄为9.3±4.6岁,49%的损伤发生在11至16岁的患者中。眼球穿通是最常见的损伤类型(63.3%),最常发生于角膜(63.3%)。木质物体是最常见的致伤原因。手术干预后,40.8%的患者最终视力(VA)≥6/60。51%的病例进行了玻璃体切除术,其中只有36%的患者最终视力≥6/60。视网膜脱离的存在是影响视力提高超过一行的唯一具有统计学意义的因素(优势比0.05,p<0.001)。小儿眼外伤患者中经常观察到角膜穿通。与视网膜未脱离的开放性眼球患者相比,视网膜脱离的小儿患者最终视力差的可能性显著更高。尽管进行了及时的手术干预,但在需要玻璃体切除术的患者中,不到一半的患者保留了有用视力。