Hebei Provincial Eye institute, Hebei Provincial Eye Hospital, Xingtai, Hebei, 054001, China.
Tianjin Medical University Eye Hospital/Eye Institute, School of Optometry and Ophthalmology, Tianjin Medical University, Tianjin, 300384, China.
Sci Rep. 2019 Aug 30;9(1):12612. doi: 10.1038/s41598-019-48862-2.
Ocular trauma is a major cause of monocular blindness worldwide. Vitrectomy at correct timing can significantly improve the efficacy and prognosis, but the timing of vitrectomy has remained highly controversial for decades. Trauma cases are different from each other, thus, a flexible timing system based on the details of each individual case is recommended. Unfortunately, no such a timing system is available for clinical application up to now. To establish the vitrectomy timing individualization system for ocular trauma (VTISOT), we first identified 6 independent tPVR risk factors (including Zone 3 Injury, Zone 3 retinal Laceration, Massive Vitreous Hemorrhage, Retinal Disorder, Timing of Vitrectomy and Type of Injury) by retrospective study. Then, the tPVR score was established by binary logistic regression analysis. Most importantly and critically, the vitrectomy timing individualization system for ocular trauma was established based on the identified tPVR risk factors and the tPVR score. The following evaluation of the VTISOT showed that the patients consistent with the VTISOT principles exhibited reduced tPVR incidence and better surgical results. In short, the VTISOT principles were established, which may provide a new approach to individualize the timing of vitrectomy and improve the prognosis after trauma.
眼外伤是全球单眼盲的主要原因。适时的玻璃体切除术可以显著提高疗效和预后,但玻璃体切除术的时机几十年来一直存在很大争议。创伤病例彼此不同,因此,建议根据每个病例的详细情况制定灵活的时机系统。不幸的是,迄今为止,还没有这样的时机系统可用于临床应用。为了建立眼外伤玻璃体切除术时机个体化系统(VTISOT),我们首先通过回顾性研究确定了 6 个独立的 tPVR 风险因素(包括 3 区损伤、3 区视网膜裂伤、大量玻璃体出血、视网膜病变、玻璃体切除术时机和损伤类型)。然后,通过二项逻辑回归分析建立 tPVR 评分。最重要和关键的是,根据确定的 tPVR 风险因素和 tPVR 评分建立了眼外伤玻璃体切除术时机个体化系统。对 VTISOT 的以下评估表明,符合 VTISOT 原则的患者 tPVR 发生率降低,手术效果更好。简而言之,已经确立了 VTISOT 原则,这可能为个体化玻璃体切除术时机提供新方法,并改善创伤后的预后。