Hassan Naqvi Syed Abid, Malik Sidra, Syed Zulfiqar Ud Din, Anwar Syeda Birjees, Nayyar Shahzad
Eye Department, CMH, Peshawar, National University of Medical Sciences (NUMS), Rawalpindi.
AFIP, National University of Medical Sciences (NUMS), Rawalpindi.
J Pak Med Assoc. 2017 Dec;67(12):1853-1856.
To determine the visual outcome and its prognostic factors in patients presenting with ocular war injuries.
This descriptive, observational study was conducted at the Combined Military Hospital, Peshawar, Pakistan, from June 2012 to March 2016, and comprised soldiers with ocular war injuries. Informed consent was obtained from all participants. A predesigned proforma was used to record patient's demographic details along with the cause, side, type and severity of injury. Injuries were classified as open globe or closed globe injuries. Ocular trauma score grade was used to describe the severity of injury.
There were 210 participants with an overall mean age of 29.34±5.35 years (range: 20-43 years). All of them were male. Left side was more frequently involved, i.e. in 126(60%) cases. The most frequent underlying cause was improvised explosive device blast injury 114(54.3%), followed by blunt trauma 42(20%) and road traffic accidents 24(11.4%). Closed globe injuries were more frequent and were recorded in 120(57.1%) patients. The visual outcome was good in 62(29.5%) patients, followed by fair in 51(24.3%) patients while 51(24.3%) patients had worst visual outcome. When stratified, there was no significant difference of worst visual outcome with patient's age (p=0.279). However, improvised explosive device blast (p=0.002), open globe injury (p=0.000), ocular trauma score grade 1; open globe (p=0.049), closed globe (p=0.003) were associated with significantly higher frequency of worst visual outcome. Zone-III injury was also prognostic of worst visual outcome, but the difference was significant only in case of open globe injury (p=0.003).
Improvised explosive device blast, open globe injury and ocular trauma score grade 1 were poor prognostic features and resulted in significantly higher frequency of poor visual outcome.
确定眼部战争伤患者的视力预后及其预后因素。
本描述性观察性研究于2012年6月至2016年3月在巴基斯坦白沙瓦联合军事医院进行，研究对象为眼部战争伤士兵。所有参与者均获得知情同意。使用预先设计的表格记录患者的人口统计学细节以及损伤的原因、部位、类型和严重程度。损伤分为开放性眼球损伤或闭合性眼球损伤。采用眼外伤评分等级来描述损伤的严重程度。
共有210名参与者，总体平均年龄为29.34±5.35岁（范围：20 - 43岁）。所有参与者均为男性。左侧受伤更为常见，即126例（60%）。最常见的潜在原因是简易爆炸装置爆炸伤114例（54.3%），其次是钝挫伤42例（20%）和道路交通事故24例（11.4%）。闭合性眼球损伤更为常见，120例（57.1%）患者有此损伤。62例（29.5%）患者视力预后良好，51例（24.3%）患者视力预后中等，51例（24.3%）患者视力预后最差。分层分析时，患者年龄与最差视力预后无显著差异（p = 0.279）。然而，简易爆炸装置爆炸伤（p = 0.002）、开放性眼球损伤（p = 0.000）、眼外伤评分1级；开放性眼球损伤（p = 0.049）、闭合性眼球损伤（p = 0.003）与最差视力预后的发生率显著较高相关。Ⅲ区损伤也预示着最差视力预后，但仅在开放性眼球损伤时差异有统计学意义（p = 0.003）。
简易爆炸装置爆炸伤、开放性眼球损伤和眼外伤评分1级是不良预后特征，导致视力不良预后的发生率显著更高。
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