Ghoraba Hammouda Hamdy, Heikal Mohamed Amin, Mansour Hosam Osman, Abdelfattah Haithem Mamon, Elgemai Emad Mohamed, Zaky Adel Galal
Tanta University, Tanta, Egypt; Magrabi Eye Hospital, Tanta, Egypt.
Benha University, Benha, Egypt.
J Ophthalmol. 2016;2016:1487407. doi: 10.1155/2016/1487407. Epub 2016 Oct 3.
The aim of this study is to report the difference in either anatomical or functional outcome of vitreoretinal intervention in cases of gunshot perforating eye injury if done 2-4 weeks or after the 4th week after the original trauma. Patients were treated with pars plana vitrectomy and silicon oil. Surgeries were performed in the period from February 2011 until the end of December 2014. 253 eyes of 237 patients were reviewed. 46 eyes were excluded. 207 eyes of 197 patients were analyzed. The included eyes were classified based on the timing of vitrectomy in relation to the initial trauma into two groups: 149 eyes (the first group) operated on between the 3rd and the 4th week and 58 eyes (the second group) operated on after the 4th week after the trauma. Following one surgical intervention, in the first group, attached retina was achieved in 93.28% of patients. In the second group, attached retina was achieved in 96.55% of patients. All RD cases could be attached by a second surgery. Visual acuity improved in 81.21% of patients, did not change in 15.43% of patients, and declined in 3.35% of patients. In the second group, visual acuity improved in 81.03% of patients, did not change in 12.06% of patients, and worsened in 6.89% of patients. There was no statistically significant difference between the two groups in either anatomical or functional results. We recommend interfering before the 5th week after the trauma as retinal detachment is encountered more in cases operated on after the 4th week. The visual outcome depends on the site of entry and exit (the route of gunshot).
本研究的目的是报告在枪伤性眼球穿孔伤病例中，玻璃体视网膜干预在伤后2 - 4周或第4周之后进行时，其解剖学或功能结局的差异。患者接受了玻璃体切割术和平板硅油填充术。手术于2011年2月至2014年12月底期间进行。对237例患者的253只眼进行了回顾性研究。排除46只眼。对197例患者的207只眼进行了分析。纳入的眼根据玻璃体切除术与初始创伤的时间关系分为两组：第一组149只眼（在伤后第3至4周进行手术）和第二组58只眼（在伤后第4周之后进行手术）。经过一次手术干预后，第一组中93.28%的患者视网膜复位。第二组中96.55%的患者视网膜复位。所有视网膜脱离病例均可通过二次手术复位。81.21%的患者视力提高，15.43%的患者视力不变，3.35%的患者视力下降。在第二组中，81.03%的患者视力提高，12.06%的患者视力不变，6.89%的患者视力恶化。两组在解剖学或功能结果方面均无统计学显著差异。我们建议在伤后第5周之前进行干预，因为在第4周之后进行手术的病例中视网膜脱离更为常见。视觉结局取决于入口和出口的位置（枪伤路径）。
