Madhusudhan A/L Paramananda, Evelyn-Tai Li Min, Zamri Noordin, Adil Hussein, Wan-Hazabbah Wan Hitam
Department of Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia ; Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia.
Int J Ophthalmol. 2014 Jun 18;7(3):486-90. doi: 10.3980/j.issn.2222-3959.2014.03.18. eCollection 2014.
To identify the aetiology of open globe injuries at Hospital Universiti Sains Malaysia over a period of 10y and the prognostic factors for visual outcome.
Retrospective review of medical records of open globe injury cases that presented from January 2000 to December 2009. Classification of open globe injury was based on the Birmingham Eye Trauma Terminology (BETT). Records were obtained with hospital permission via the in-house electronic patient management system, and the case notes of all patients with a diagnosis of open globe injury were scrutinised. Patients with prior ocular trauma, pre-existing ocular conditions affecting the visual acuity, contrast sensitivity, central vision or corneal thickness, as well as those with a history of previous intraocular or refractive surgery were excluded. Analysis of data was with SPSS version 20.0. Ordinal logistic regression analysis was used to examine the association between prognostic factors and visual outcome.
This study involved 220 patients (n=222 eyes). The most common place of injury was the home (51.8%), followed by the workplace (23.4%). Among children aged less than 16y of age, domestic-related injury was the predominant cause (54.6%), while in those aged 16y and above, occupational injuries were the most common cause (40.0%). Most eyes (76.5%) had an initial visual acuity worse than 3/60, and in half of these, the visual acuity improved. The visual outcome was found to be significantly associated with the initial visual acuity (P<0.005), posterior extent of wound (P<0.001), length of wound (P<0.001), presence of hyphaema (P<0.001) and presence of vitreous prolapse ((P<0.005).
The most common causes of open globe injury are domestic accidents and occupational injuries. Significant prognostic factors for final visual outcome in patients with open globe injury are initial visual acuity, posterior extent and length of wound, presence of hyphaema and presence of vitreous prolapse. Awareness of the factors predicting a poor visual outcome may be helpful during counselling of patients with open globe injuries.
确定马来西亚理科大学医院10年间开放性眼球损伤的病因及视力预后的相关因素。
回顾性分析2000年1月至2009年12月期间开放性眼球损伤病例的医疗记录。开放性眼球损伤的分类基于伯明翰眼外伤术语（BETT）。经医院许可，通过内部电子患者管理系统获取记录，并仔细审查所有诊断为开放性眼球损伤患者的病历。排除既往有眼外伤、存在影响视力、对比敏感度、中心视力或角膜厚度的眼部疾病，以及有既往眼内手术或屈光手术史的患者。使用SPSS 20.0版进行数据分析。采用有序逻辑回归分析来检验预后因素与视力预后之间的关联。
本研究纳入220例患者（222只眼）。最常见的受伤地点是家中（51.8%），其次是工作场所（23.4%）。在16岁以下儿童中，家庭相关损伤是主要原因（54.6%），而在16岁及以上人群中，职业损伤是最常见的原因（40.0%）。大多数眼（76.5%）初始视力低于3/60，其中一半患者视力有所改善。发现视力预后与初始视力（P<0.005）、伤口后段范围（P<0.001）、伤口长度（P<0.001）、前房积血的存在（P<0.001）和玻璃体脱出的存在（P<0.005）显著相关。
开放性眼球损伤最常见的原因是家庭事故和职业损伤。开放性眼球损伤患者最终视力预后的重要预后因素是初始视力、伤口后段范围和长度、前房积血的存在以及玻璃体脱出的存在。了解预测视力预后不良的因素可能有助于对开放性眼球损伤患者进行咨询。
