Prendes Mark A, Jian-Amadi Arash, Chang Shu-Hong, Shaftel Solomon S
Department of Ophthalmology, Division of Oculoplastics, University of Washington School of Medicine, Seattle, Washington, U.S.A.
Ophthalmic Plast Reconstr Surg. 2016 Jul-Aug;32(4):279-83. doi: 10.1097/IOP.0000000000000501.
Canine bites frequently result in periocular injury. The authors aimed to further characterize the dog breeds, types of injuries inflicted, and treatment outcomes.
A retrospective chart review was performed on all dog bites recorded in the University of Washington trauma registry from 2003 to 2013. Cases involving ocular injury were further investigated to identify ocular tissues affected, treatment patterns, and outcomes.
A total of 342 dog bite victims were identified, of whom 91 sustained ocular trauma (27%). The mean age of patients with ocular injuries was significantly lower than those without (14.1 ± 1.9 vs. 30.0 ± 1.3 years, p < 0.001). Children bitten by dogs were 4.2 times more likely to sustain ocular injuries than adults (45.2% vs. 10.8%). The most common breed of dog inflicting ocular injury was the pit bull (25%). Forty percent of patients with ocular trauma sustained canalicular lacerations and epiphora was noted in only 3 patients (8%) after repair. Three percent had orbital fractures and 2% sustained ruptured globes. Infections were rare, affecting only 2% of patients.
To our knowledge, this study is the largest to date to report the incidence and characteristics of ocular injuries sustained from dog bites. These injuries were disproportionately more common in children and have a high incidence of canalicular laceration. Though rare, globe injuries and orbital fractures were seen in this population. Importantly, this study establishes that pit bulls are the most frequent breed associated with ocular injuries from dog bites.
犬咬伤常导致眼周损伤。作者旨在进一步明确犬的品种、造成的损伤类型及治疗结果。
对华盛顿大学创伤登记处2003年至2013年记录的所有犬咬伤病例进行回顾性图表分析。对涉及眼损伤的病例进一步调查,以确定受影响的眼组织、治疗方式及结果。
共确定342名犬咬伤受害者,其中91人遭受眼外伤(27%)。眼外伤患者的平均年龄显著低于未受伤者(14.1±1.9岁对30.0±1.3岁,p<0.001)。被犬咬伤的儿童发生眼外伤的可能性是成人的4.2倍(45.2%对10.8%)。造成眼外伤最常见的犬种是比特斗牛梗(25%)。40%的眼外伤患者发生泪小管撕裂伤,修复后仅3例(8%)出现溢泪。3%的患者有眼眶骨折,2%的患者发生眼球破裂。感染罕见,仅影响2%的患者。
据我们所知,本研究是迄今为止报告犬咬伤所致眼外伤发病率和特征的最大规模研究。这些损伤在儿童中更为常见,泪小管撕裂伤发生率高。虽然罕见,但该人群中可见眼球损伤和眼眶骨折。重要的是,本研究证实比特斗牛梗是与犬咬伤所致眼外伤最相关的犬种。