Han Yong S, Kavoussi Shaheen C, Adelman Ron A
Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT, USA.
Clin Ophthalmol. 2015 Aug 11;9:1443-8. doi: 10.2147/OPTH.S87852. eCollection 2015.
The purpose of this study was to analyze eyes presenting with no light perception (NLP) after open globe injury (OGI) to determine visual outcomes and prognostic indicators for visual recovery.
The records of consecutive patients with at least 6 months of follow-up presenting with OGI and NLP to a single institution between January 1, 2003 and December 31, 2013 were reviewed for demographics, ophthalmic history, context and characteristics of injury, ocular examination findings, surgical interventions, and follow-up visual acuity. Unpaired t-tests and Fisher's Exact tests were used for statistical analysis.
Twenty-five patients met our inclusion criteria. The mean age was 50.4±25.5 (range 8-91) years. Four patients (16%) regained vision (hand motion in three patients and light perception in one patient) while 21 patients (84%) remained with NLP or had a prosthesis at final follow-up. Fourteen eyes (56%) were enucleated; nine (36%) were secondary enucleations. Although the sample sizes were small, neither ocular trauma score nor wound size was found to predict visual recovery.
Four patients regained some vision after presenting with NLP due to OGI. These findings suggest that, in select cases, physicians should discuss the possibility of regaining some vision.
本研究旨在分析开放性眼球损伤（OGI）后无光感（NLP）的眼部情况，以确定视觉预后和视觉恢复的预后指标。
回顾了2003年1月1日至2013年12月31日期间在单一机构就诊的连续性开放性眼球损伤且无光感患者的记录，这些患者至少随访了6个月，记录内容包括人口统计学资料、眼科病史、损伤的背景和特征、眼部检查结果、手术干预措施以及随访时的视力。采用非配对t检验和Fisher精确检验进行统计分析。
25例患者符合纳入标准。平均年龄为50.4±25.5（范围8 - 91）岁。4例患者（16%）恢复了视力（3例患者恢复到手动，1例患者恢复到光感），而21例患者（84%）在最终随访时仍无光感或安装了义眼。14只眼（56%）被摘除眼球；9只眼（36%）为二期眼球摘除。尽管样本量较小，但未发现眼外伤评分和伤口大小可预测视觉恢复情况。
4例因开放性眼球损伤导致无光感的患者恢复了一定视力。这些发现表明，在某些情况下，医生应讨论恢复一定视力的可能性。
