Gill Ekjyot, Shulman Matthew, Schechet Sid, Grumbine Lawson
University of Maryland, Baltimore, MD, USA.
GMS Ophthalmol Cases. 2017 Jul 7;7:Doc17. doi: 10.3205/oc000068. eCollection 2017.
Cases of penetrating ocular trauma due to osseous material are limited, so reported incidents are valuable in determining outcomes and proper treatment courses. We report a case of an open globe injury of the left eye with an intraocular foreign body occurring after a firework exploded in the hand of a 22-year-old man. The patient presented with light perception vision in the injured eye with a full-thickness limbal laceration and dense hyphema obscuring fundoscopy. CT scan revealed a hyperdense foreign body juxtaposed to the lens. Immediate surgical intervention to repair the globe rupture revealed a defect in the anterior capsule and small, white objects in the posterior chamber that were promptly removed. Pathologic investigation determined these fragments to be cortical bone likely from the patient's phalanges. There was no evidence of endophthalmitis or keratitis from time of injury to the five-month follow-up, suggesting that the risk of infection may be low and therefore it may be reasonable to manage these injuries with a period of observation.
因骨质材料导致的穿透性眼外伤病例有限,因此报告的事件对于确定治疗结果和合适的治疗方案具有重要价值。我们报告一例22岁男性手持烟花爆炸后发生的左眼开放性眼球损伤并伴有眼内异物的病例。患者受伤眼仅存光感,角膜缘全层裂伤,浓密前房积血遮挡眼底检查。CT扫描显示高密度异物紧邻晶状体。立即进行手术修复眼球破裂,发现前囊膜有缺损,后房有小的白色物体,遂立即取出。病理检查确定这些碎片为可能来自患者指骨的皮质骨。从受伤到五个月随访期间均无眼内炎或角膜炎迹象,提示感染风险可能较低,因此对这些损伤进行一段时间的观察处理可能是合理的。