中国北方某三级医院晶状体异物的视觉预后及预后因素
Visual Outcomes and Prognostic Factors of Intralenticular Foreign Bodies in a Tertiary Hospital in North China.
作者信息
Han Shaolei, Wang Tingting, Jia Jinchen, Sun Suhuan, Fan Yiming, Yang Guoxing, Yang Zanzhang
机构信息
Department of Ophthalmology, Hebei Provincial Key Laboratory of Ophthalmology, Hebei Eye Hospital, Xingtai, Hebei Province 054000, China.
出版信息
J Ophthalmol. 2019 Oct 13;2019:4964595. doi: 10.1155/2019/4964595. eCollection 2019.
PURPOSE
The aim of this study is to describe the epidemiological and visual outcomes and to identify the main prognostic factors of intralenticular foreign body (ILFB) injuries.
METHODS
We performed a retrospective review of 21 patients (21 eyes) referred to Hebei Eye Hospital in North China from January 2012 to December 2017, who underwent surgical removal of ILFBs and associated ocular trauma repairs. Data regarding the patient demographics, cause of the injury, nature of the ILFB, clinical features, time interval between the injury and the ILFB removal, time interval between the presentation and the surgery, and the initial and final best-corrected visual acuities (BCVAs) were analyzed, and the main prognostic factors were identified.
RESULTS
Male adults were most affected by ILFBs (90.5%). The mean age of the patients was 41.5 years (median: 46 years, range: 21 to 60 years). None of the patients were wearing goggles at the time of the injury. The most common ILFB cause was hammering the metal (57.1%), and most of the ILFBs were metallic (71.4%). After medical treatment, the final BCVA was improved significantly ( = 2.49, =0.015). There was a significant association between the ILFBs with posterior segment injuries and the final BCVA ( = 10.03, =0.01). Those factors showing no statistical association with the final BCVA included the age ( = 0.36, =1.0), gender ( = 0.52, =1.0), nature of the ILFB ( = 1.11, =0.54), entrance wound location ( = 2.85, =0.25), and time interval between the injury and the ILFB removal ( = 1.87, =0.23).
CONCLUSION
This is the first local study to explore the epidemiology of ILFB injuries and to identify the main prognostic factors. There was a significant association between the ILFBs with posterior segment injuries and the final BCVA. Improved public awareness and strengthened education regarding safety are the key approaches to reduce the incidence of eye injuries.
目的
本研究旨在描述晶状体异物（ILFB）损伤的流行病学情况和视力预后，并确定主要的预后因素。
方法
我们对2012年1月至2017年12月转诊至中国北方河北眼科医院的21例患者（21只眼）进行了回顾性研究，这些患者均接受了ILFB手术摘除及相关眼外伤修复。分析了患者的人口统计学数据、受伤原因、ILFB的性质、临床特征、受伤至ILFB摘除的时间间隔、就诊至手术的时间间隔以及初始和最终最佳矫正视力（BCVA），并确定了主要的预后因素。
结果
成年男性受ILFB影响最为严重（90.5%）。患者的平均年龄为41.5岁（中位数：46岁，范围：21至60岁）。受伤时无患者佩戴护目镜。最常见的ILFB致伤原因是锤击金属（57.1%），且大多数ILFB为金属异物（71.4%）。经过治疗，最终BCVA有显著改善（=2.49，=0.015）。伴有后段损伤的ILFB与最终BCVA之间存在显著相关性（=10.03，=0.01）。与最终BCVA无统计学关联的因素包括年龄（=0.36，=1.0）、性别（=0.52，=1.0）、ILFB的性质（=1.11，=0.54）、入口伤口位置（=2.85，=0.25）以及受伤至ILFB摘除的时间间隔（=1.87，=0.23）。
结论
这是第一项探索ILFB损伤流行病学情况并确定主要预后因素的本地研究。伴有后段损伤的ILFB与最终BCVA之间存在显著相关性。提高公众安全意识并加强安全教育是降低眼外伤发生率的关键途径。
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