Tóth Gábor, Pluzsik Milán Tamás, Csákány Béla, Sándor Gábor László, Lukáts Olga, Nagy Zoltán Zsolt, Szentmáry Nóra
Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Congenital Aniridia Research, Saarland University, Kirrberger Str. 100, D-66424 Homburg/Saar, Germany.
Department of Ophthalmology, Semmelweis University, Budapest, Hungary.
J Ophthalmol. 2021 May 27;2021:5588977. doi: 10.1155/2021/5588977. eCollection 2021.
To analyse the demographic and clinical characteristics of ocular traumas resulting in enucleation/evisceration in a large tertiary referral center in a developed country (Hungary) over a period of 15 years. . A retrospective review of enucleated/eviscerated eyes that underwent surgery between 2006 and 2020 at the Department of Ophthalmology of Semmelweis University, Budapest, Hungary, due to ocular trauma as the primary indication for enucleation/evisceration. For each subject, clinical history, B-scan ultrasound report, and histopathology results were reviewed.
There were 124 enucleated/eviscerated eyes from 124 patients (91 males (73.4%)). The mean age at the time of trauma was 37.3 ± 26.0 years while the mean age at the time of enucleation/evisceration was 46.9 ± 20.3 years. The main clinical diagnoses after ocular trauma were open globe injury ( = 96; 77.4%), ocular burns ( = 6; 4.8%), traumatic optic neuropathy ( = 4; 3.2%), bulbar avulsion ( = 3; 2.4%), traumatic cataract ( = 2; 1.6%), retinal ablation ( = 1; 0.8%), and traumatic carotid-cavernous fistula ( = 1; 0.8%). Among the 124 patients, 98 (79.0%) underwent enucleation and 26 (21.0%) evisceration. Patients who underwent primary enucleation/evisceration ( = 24 19.4%) were significantly older at the time of the injury (57.7 ± 22.7 years) than people who underwent secondary eye removal (32.4 ± 24.4 years) ( < 0.0001). The mean time interval between trauma and enucleation/evisceration was 114.9 ± 163.5 months. The main clinical indications for anophthalmic surgery were atrophia/phthisis bulbi ( = 56, 45.2%), acute trauma ( = 25, 20.2%), painful blind eye due to glaucoma ( = 17, 13.7%), endophthalmitis ( = 10, 8.1%), and cosmetic reasons ( = 7, 5.6%). One patient (0.8%) had sympathetic ophthalmia.
Primary enucleation/evisceration was performed in one-fifth of all ocular trauma-related anophthalmic surgeries in our tertiary eye care center with enucleation being the most common procedure. Atrophia/phthisis bulbi was the most frequent immediate clinical indication for enucleation/evisceration.
分析在一个发达国家（匈牙利）的大型三级转诊中心，15年间因眼外伤导致眼球摘除/眼内容物剜出术的人口统计学和临床特征。回顾性分析2006年至2020年期间，在匈牙利布达佩斯塞梅尔维斯大学眼科因眼外伤作为眼球摘除/眼内容物剜出术的主要指征而接受手术的摘除/剜出眼球。对每个受试者的临床病史、B超报告和组织病理学结果进行了回顾。
124例患者的124只眼球被摘除/剜出（91例男性，占73.4%）。受伤时的平均年龄为37.3±26.0岁，而眼球摘除/眼内容物剜出时的平均年龄为46.9±20.3岁。眼外伤后的主要临床诊断为开放性眼球损伤（n = 96；77.4%）、眼部烧伤（n = 6；4.8%）、外伤性视神经病变（n = 4；3.2%）、眼球撕脱（n = 3；2.4%）、外伤性白内障（n = 2；1.6%）、视网膜切除（n = 1；0.8%）和外伤性颈内动脉海绵窦瘘（n = 1；0.8%）。在124例患者中，98例（79.0%）接受了眼球摘除术，26例（21.0%）接受了眼内容物剜出术。接受一期眼球摘除/眼内容物剜出术的患者（n = 24，19.4%）受伤时的年龄（57.7±22.7岁）显著高于接受二期眼球摘除的患者（32.4±24.4岁）（P < 0.0001）。外伤与眼球摘除/眼内容物剜出之间的平均时间间隔为114.9±163.5个月。无眼球手术的主要临床指征为眼球萎缩/眼球痨（n = 56，45.2%）、急性外伤（n = 25，20.2%）、青光眼所致疼痛性盲眼（n = 17，13.7%）、眼内炎（n = 10，8.1%）和美容原因（n = 7，5.6%）。1例患者（0.8%）发生交感性眼炎。
在我们的三级眼科护理中心，五分之一的与眼外伤相关的无眼球手术为一期眼球摘除/眼内容物剜出术，其中眼球摘除术是最常见的手术方式。眼球萎缩/眼球痨是眼球摘除/眼内容物剜出术最常见的直接临床指征。
