Department of General Medical Education.
Department of Ophthalmology, Brooke Army Medical Center, San Antonio, Texas, U.S.A.
Ophthalmic Plast Reconstr Surg. 2019 Jan/Feb;35(1):62-66. doi: 10.1097/IOP.0000000000001168.
To describe outcomes and associated ocular injuries of lateral canthotomy and cantholysis (LCC) as performed in combat ocular trauma.
Data from the Walter Reed Ocular Trauma Database of patients requiring LCC during Operations Iraqi Freedom and Enduring Freedom was reviewed as a retrospective cohort. Primary outcome measures included final visual acuity (VA) and Ocular Trauma Score. Secondary outcome measures were associated injuries and timing of surgery.
Thirty-six LCCs were recorded on a total of 890 eyes (4.04 %) in the Walter Reed Ocular Trauma Database. Eighteen out of 36 eyes (50.00%) had a final VA of the affected eye of 20/200 or worse vision. From the initial available VA measured either at the time of injury or at Walter Reed Army Medical Center, 13 eyes (40.63%) had no change in VA, 15 eyes (46.88%) had improvement, and 4 (12.5%) had a decrease in VA (n = 32, data unavailable for 4 eyes). Ocular Trauma score 0-65 was noted in 14 (38.9%) and 66-100 (61.1%). Retinal detachment (6, 16.67%), optic nerve injuries (7, 19.44%), orbital fractures (20, 55.56%), and retrobulbar hematoma (25, 69.44%) were commonly associated injuries. Of the 36 LCC, 18 (50.00%) were performed as the first surgery performed at the combat support hospital, 13 (36.11%) as the second, 4 (11.11%) as the third, and 1 (2.78%) as the fourth.
The largest subgroup of patients had an improvement in VA associated with performance of LCC; however, half of patients remained with a final VA of equal to or worse than 20/200 due to severe ocular trauma.
描述在伊拉克自由行动和持久自由行动中进行的外侧眦切开术和眦松解术（LCC）的结果和相关眼部损伤。
回顾性分析了 Walter Reed 眼部创伤数据库中需要进行 LCC 的患者数据。主要结局测量包括最终视力（VA）和眼部创伤评分。次要结局测量包括相关损伤和手术时间。
Walter Reed 眼部创伤数据库中共有 890 只眼（4.04%）记录了 36 例 LCC。36 只眼中有 18 只（50.00%）患眼最终视力为 20/200 或更差。从受伤时或 Walter Reed 陆军医疗中心最初可获得的 VA 测量值来看，13 只眼（40.63%）VA 无变化，15 只眼（46.88%）VA 改善，4 只眼（12.5%）VA 下降（n = 32，4 只眼数据不可用）。眼部创伤评分 0-65 分的有 14 例（38.9%），66-100 分的有 22 例（61.1%）。视网膜脱离（6 例，16.67%）、视神经损伤（7 例，19.44%）、眼眶骨折（20 例，55.56%）和球后血肿（25 例，69.44%）是常见的相关损伤。36 例 LCC 中，18 例（50.00%）在战斗支援医院首次手术中进行，13 例（36.11%）在第二次手术中进行，4 例（11.11%）在第三次手术中进行，1 例（2.78%）在第四次手术中进行。
最大的亚组患者 VA 改善与 LCC 相关；然而，由于严重的眼部创伤，一半的患者最终视力仍等于或低于 20/200。
