Ratanapakorn Tanapat, Kongmalai Parichat, Sinawat Suthasinee, Sanguansak Thuss, Bhoomibunchoo Chavakij, Laovirojjanakul Wipada, Yospaiboon Yosanan
KKU Eye Center, Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Chaophrayayommarat Hospital, Suphanburi, Thailand.
Clin Ophthalmol. 2021 Jan 5;14:4587-4593. doi: 10.2147/OPTH.S290619. eCollection 2020.
To study the visual outcomes and identify the predictive factors for visual outcomes in patients with eye injuries and retained intraocular foreign bodies (IOFBs).
The medical records of 359 consecutive patients with eye injuries and retained IOFBs were retrospectively reviewed during 2009-2018. Demographic data, clinical findings, treatment and visual outcomes were studied. Univariate and multivariate analyses were used to identify the predictive factors.
Most of the patients were male and the average age was 36.4 years old. The three most common causes of eye injuries were grass trimming (25.07%), chiseling (23.12%) and hammering (13.93%). Most of the patients (79.39%) presented with poor initial best-corrected visual acuity (BCVA) (<3/60). Pars plana vitrectomy with IOFB removal was done in 273 eyes (76.04%). After treatment, eyes with poor BCVA (<3/60) decreased from 79.39% to 62.95% and eyes with good BCVA (≥3/60) increased from 20.61% to 37.05%. Poor initial best-corrected visual acuity (odds ratio 23.39, P<0.001), rhegmatogenous retinal detachment (odds ratio 9.91, P<0.001) and the presence of infectious endophthalmitis (odds ratio 2.06, P=0.02) were statistically significant predictive factors for poor visual outcome.
Most patients with eye injuries and IOFBs usually have poor final BCVA. Poor presenting BCVA, retinal detachment and endophthalmitis are significant predictive factors for poor visual outcomes. These factors can be used to inform the visual prognosis and plan prompt surgical intervention for the patients. Causes of IOFBs were mostly work-related and could be preventable. Education and activation of using appropriate protective safety glasses during work are necessary to avoid serious eye injuries and blindness.
研究眼外伤合并眼内异物（IOFBs）患者的视力预后，并确定视力预后的预测因素。
回顾性分析2009年至2018年期间359例连续的眼外伤合并眼内异物患者的病历。研究人口统计学数据、临床发现、治疗及视力预后情况。采用单因素和多因素分析来确定预测因素。
大多数患者为男性，平均年龄36.4岁。眼外伤的三个最常见原因是修剪草坪（25.07%）、凿击（23.12%）和锤击（13.93%）。大多数患者（79.39%）初始最佳矫正视力（BCVA）较差（<3/60）。273只眼（76.04%）行玻璃体切割联合眼内异物取出术。治疗后，BCVA较差（<3/60）的眼从79.39%降至62.95%，BCVA较好（≥3/60）的眼从20.61%增至37.05%。初始最佳矫正视力差（比值比23.39，P<0.001）、孔源性视网膜脱离（比值比9.91，P<0.001）和感染性眼内炎的存在（比值比2.06，P=0.02）是视力预后差的统计学显著预测因素。
大多数眼外伤合并眼内异物患者最终BCVA通常较差。初始BCVA差、视网膜脱离和眼内炎是视力预后差的重要预测因素。这些因素可用于告知患者视力预后情况并计划及时的手术干预。眼内异物的原因大多与工作相关且可预防。工作期间进行教育并促使使用适当的防护安全眼镜对于避免严重眼外伤和失明是必要的。
