Harvey Morgan M, Justin Grant A, Brooks Daniel I, Ryan Denise S, Weichel Eric D, Colyer Marcus H
Department of Flight Medicine, Expeditionary Medical Facility, Camp Lemonnier, Djibouti.
Department of Ophthalmology, Brooke Army Medical Center, San Antonio, TX, USA.
Ophthalmic Epidemiol. 2021 Aug;28(4):312-321. doi: 10.1080/09286586.2020.1828494. Epub 2020 Sep 30.
To update the epidemiology of ocular injuries in soldiers admitted to Walter Reed Army Medical Center (WRAMC) from 2001 to 2011 after sustaining combat injuries in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF).
Data were collected in the Walter Reed Ocular Trauma Database. A Bayesian Network Analysis was completed to better understand the relationships between different ocular demographic variables, injuries, surgeries, ocular trauma scores (OTS) and visual outcomes.
There were 890 consecutive globe or adnexal combat injuries, or both, sustained by 652 United States soldiers treated at WRAMC between 2001 and 2011.The primary mechanism of injury was improvised explosive device (62.47%). Many patients (62.0%) had final visual acuity (VA) grades of 1-2 (20/15 - 20/200), while 29.9% of patients had final VA grades of 3-5 (less than 20/200), and 8.1% had unknown final VA grades. Bayesian Network Analysis revealed that the injury variables of Retina (47.9%), Lens (44.6%), Posterior Segment (43.7%) and Anterior Segment (40.3%), and the surgical variables of Enucleation (97.6%) and cataract extraction and posterior capsule intraocular lens placement (CEPCIOL; 43.3%) all had probabilities greater than 40% for a poor final VA, while all other variables were less than 40%.
Modern-day combat trauma results in complicated ocular injuries causing 30% of patients to be left legally blind in their injured eye. It is critical to maintain a wide variety of deployable, specialty trained ophthalmologists to ensure the best visual outcomes for wounded warriors and to maintain mission readiness.
更新2001年至2011年在伊拉克自由行动（OIF）和持久自由行动（OEF）中遭受战斗损伤后入住沃尔特里德陆军医疗中心（WRAMC）的士兵眼部损伤的流行病学情况。
在沃尔特里德眼部创伤数据库中收集数据。完成了贝叶斯网络分析，以更好地了解不同眼部人口统计学变量、损伤、手术、眼外伤评分（OTS）和视觉结果之间的关系。
2001年至2011年期间，WRAMC治疗的652名美国士兵连续发生了890例眼球或附属器战斗损伤，或两者皆有。主要损伤机制是简易爆炸装置（62.47%）。许多患者（62.0%）的最终视力（VA）等级为1 - 2（20/15 - 20/200），而29.9%的患者最终VA等级为3 - 5（低于20/200），8.1%的患者最终VA等级未知。贝叶斯网络分析显示，视网膜（47.9%）、晶状体（44.6%）、后段（43.7%）和前段（40.3%）的损伤变量，以及眼球摘除术（97.6%）和白内障摘除及后囊内人工晶状体植入术（CEPCIOL；43.3%）的手术变量，最终视力不佳的概率均大于40%，而所有其他变量均小于40%。
现代战斗创伤导致复杂的眼部损伤，使30%的患者受伤眼法定失明。维持大量可部署的、经过专业培训的眼科医生对于确保受伤战士获得最佳视觉结果并保持任务准备状态至关重要。
