Teixeira Sérgio M, Bastos Ricardo R, Falcão Manuel S, Falcão-Reis Fernando M, Rocha-Sousa Amândio A
Department of Senses Organs, Faculty of Medicine, University of Porto, Porto - Portugal.
Eur J Ophthalmol. 2014 Nov-Dec;24(6):932-9. doi: 10.5301/ejo.5000471. Epub 2014 Apr 16.
To describe the epidemiology, characteristics, surgical management, functional outcome, and prognostic factors of open-globe injuries requiring surgical treatment.
A retrospective review of 180 patients who underwent surgical repair of an open-globe injury at the ophthalmology emergency department of the Hospital S. João (Porto-Portugal) was performed. Prognostic factors for no light perception and for poor vision (visual acuity <3/10) in patients who retained vision after surgical treatment were determined.
We observed a different age distribution between male and female ocular trauma (143 patients were men, with a mean age of 46.4 years, while the mean age for women was 70.9 years). Domestic accidents were the most frequent context of trauma (44.4%). However, work accidents constituted the principal context of trauma among men. Initial visual acuity, concomitant adnexa lesion, associated nonocular trauma, and intentionally caused trauma were predictors of no vision at the end of the follow-up. Older age, lens damage, and retinal detachment were predictors of poor vision in patients with retained visual acuity. Vitreous hemorrhage, posterior segment lesion, and simultaneous lesion of anterior and posterior segment anticipated both no vision and poor vision. Isolated anterior segment lesion was associated with vision survival and good vision (≥3/10).
The prognostic factors identified in this study may aid the process of decision-making in 2 crucial moments: at the initial approach and during the follow-up of patients with vision survival after open-globe injuries.
描述需要手术治疗的开放性眼球损伤的流行病学、特征、手术管理、功能结局及预后因素。
对在圣若昂医院（葡萄牙波尔图）眼科急诊科接受开放性眼球损伤手术修复的180例患者进行回顾性研究。确定手术治疗后仍有视力的患者无光感及视力差（视力<3/10）的预后因素。
我们观察到男性和女性眼外伤的年龄分布不同（143例为男性，平均年龄46.4岁，而女性平均年龄为70.9岁）。家庭事故是最常见的外伤背景（44.4%）。然而，工伤事故是男性外伤的主要背景。初始视力、伴有附属器损伤、合并非眼部外伤及故意造成的外伤是随访结束时无光感的预测因素。年龄较大、晶状体损伤及视网膜脱离是有视力患者视力差的预测因素。玻璃体积血、眼后段损伤以及眼前段和眼后段同时损伤预示着无光感和视力差。孤立的眼前段损伤与视力保留及良好视力（≥3/10）相关。
本研究确定的预后因素可能有助于在两个关键时刻的决策过程：在初始处理时以及开放性眼球损伤后有视力患者的随访期间。
