Moreno Liliana, Velasquez Luis F, Restrepo Carlos A, Paulo Jose D, Donado Jorge, Muñoz Marta L, Aristizabal John J
Departmento Ophthalmology. Pablo Tobón Uribe Hospital, Universidad Pontificia Bolivariana, Medellin, Colombia.
Department of Surgery, Pablo Tobón Uribe Hospital. Universidad Pontificia Bolivariana, Medellin, Colombia.
Colomb Med (Cali). 2013 Dec 31;44(4):218-23. eCollection 2013 Oct.
Currently ocular combat injuries are complex and associated with poor visual outcomes. Our objective is to characterize the military population that suffer land mine combat ocular trauma in Colombia and identify the type of wound, treatment and visual outcomes.
Retrospectively review of medical history of soldiers evaluated in Pablo Tobon Uribe Hospital, whom had land mine trauma during January of 2004 and December 2012.
635 soldiers had land mine trauma, 153 of them had ocular trauma (226 eyes). Open ocular trauma was observed in 29.6%. The Ocular Trauma Score was calculated in 183 eyes, the initial visual acuity was not possible to be reported in the rest of them; the 45% of the eyes were classified in category 3. Three patients had no light perception in both eyes. 97.3% of the eyes received medical treatment and 49.1% had surgery also. Primary evisceration was made in 5.8% and enucleation in 1.8%. Intraocular foreign body was observed by ultrasonography in 11.1% and in 5.8% by orbital tomography. Eleven patients were legally blind at discharge.
The ocular trauma related to a land mine is highly destructive at an ocular level. The treatments associated with better visual outcomes are primary closure of globe and systemic antibiotics; although the characteristics of the wound itself are the main prognostic factor. The Ocular trauma score is a useful tool for determining visual outcome in combat ocular trauma.
目前,眼部战伤情况复杂,视力预后较差。我们的目标是描述哥伦比亚遭受地雷战眼部创伤的军人情况,并确定伤口类型、治疗方法及视力预后。
回顾性分析2004年1月至2012年12月在巴勃罗·托本·乌里韦医院接受评估的有地雷创伤的士兵病历。
635名士兵有地雷创伤,其中153人有眼部创伤(226只眼)。开放性眼外伤占29.6%。对183只眼计算了眼外伤评分,其余眼无法报告初始视力;45%的眼被归类为3级。3例患者双眼无光感。97.3%的眼接受了药物治疗,49.1%的眼还接受了手术。5.8%的眼进行了一期眼内容剜出术,1.8%的眼进行了眼球摘除术。超声检查发现11.1%的眼有眼内异物,眼眶断层扫描发现5.8%的眼有眼内异物。11名患者出院时法定失明。
与地雷相关的眼外伤在眼部层面具有高度破坏性。与更好视力预后相关的治疗方法是眼球一期缝合和全身使用抗生素;尽管伤口本身的特点是主要的预后因素。眼外伤评分是确定战伤性眼外伤视力预后的有用工具。