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战斗性眼外伤继发的外伤性白内障

Traumatic cataracts secondary to combat ocular trauma.

作者信息

Smith Michael P, Colyer Marcus H, Weichel Eric D, Stutzman Richard D

机构信息

From the Ophthalmology Service (Smith, Colyer, Stutzman), Department of Surgery, Walter Reed National Military Medical Center, Bethesda, and the Retina Group of Washington (Weichel), Greenbelt, Maryland, USA.

From the Ophthalmology Service (Smith, Colyer, Stutzman), Department of Surgery, Walter Reed National Military Medical Center, Bethesda, and the Retina Group of Washington (Weichel), Greenbelt, Maryland, USA.

出版信息

J Cataract Refract Surg. 2015 Aug;41(8):1693-8. doi: 10.1016/j.jcrs.2014.12.059.

Abstract

PURPOSE

To describe the characteristics, visual outcomes, and predictive value of the Ocular Trauma Score (OTS) in eyes with traumatic cataract from combat ocular trauma.

SETTING

Walter Reed Army Medical Center, Washington, DC, USA.

DESIGN

Retrospective case series.

METHODS

Records of service members with traumatic cataract from combat ocular trauma over a 7-year period were reviewed. Visual acuity at initial presentation and visual acuity at the final follow-up were compared in addition to outcomes in closed versus open globes, by final lens status, and in eyes receiving primary versus secondary intraocular lenses (IOLs). Visual outcomes were predicted using the OTS and compared to the achieved corrected distance visual acuity (CDVA).

RESULTS

A total of 181 eyes of 167 patients were included in the final analysis. Twenty-six percent of all eye injuries sustained traumatic cataract. The mean final visual outcome was 0.86 logMAR ± 1.01 (SD) with 44 no light perception (NLP) eyes and 26 light perception (LP) eyes compared with an initial visual acuity of 2.41 ± 0.88 logMAR with 27 no NLP eyes and 64 LP eyes (P ≤ .001, 2-tailed Student t test). Final CDVAs in eyes receiving primary IOLs were 0.72 ± 0.84 logMAR with 1 NLP and 1 LP eye versus 0.51 ± 0.78 logMAR with 2 LP eyes in eyes receiving a secondary IOL (P = .37, Student t test).

CONCLUSION

Traumatic cataracts are frequently associated with ocular trauma. The OTS is a reliable means of predicting visual outcome. There was no difference in eyes receiving primary IOLs versus secondary IOLs.

FINANCIAL DISCLOSURE

No author has a financial or proprietary interest in any material or method mentioned.

摘要

目的

描述眼部创伤评分(OTS)在战斗性眼外伤所致外伤性白内障眼中的特征、视力预后及预测价值。

设置

美国华盛顿特区沃尔特里德陆军医疗中心。

设计

回顾性病例系列研究。

方法

回顾7年间战斗性眼外伤所致外伤性白内障军人的病历。比较初诊时视力与最终随访时视力,此外还比较了闭合眼球与开放性眼球的预后、最终晶状体状态以及接受一期人工晶状体(IOL)与二期人工晶状体植入术的眼的预后。使用OTS预测视力预后,并与实际获得的矫正远视力(CDVA)进行比较。

结果

最终分析纳入了167例患者的181只眼。所有眼外伤中有26%发生外伤性白内障。最终平均视力预后为0.86 logMAR±1.01(标准差),其中44只眼无光感(NLP),26只眼有光感(LP);相比之下,初诊时视力为2.41±0.88 logMAR,27只眼无光感,64只眼有光感(双侧Student t检验,P≤0.001)。接受一期IOL植入术的眼中最终CDVA为0.72±0.84 logMAR,1只眼无光感,1只眼有光感;接受二期IOL植入术的眼中最终CDVA为0.51±0.78 logMAR,2只眼有光感(Student t检验,P = 0.37)。

结论

外伤性白内障常与眼外伤相关。OTS是预测视力预后的可靠方法。接受一期IOL植入术与二期IOL植入术的眼之间无差异。

财务披露

无作者对文中提及的任何材料或方法有财务或专利权益。

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