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中国中部地区成人严重开放性眼球损伤的临床分析

Clinical Analysis of Adult Severe Open-Globe Injuries in Central China.

作者信息

Chen Hongling, Han Junjun, Zhang Xianliang, Jin Xuemin

机构信息

Department of Ophthalmology, Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.

Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

Front Med (Lausanne). 2021 Oct 27;8:755158. doi: 10.3389/fmed.2021.755158. eCollection 2021.

Abstract

To describe the characteristics, management, and outcomes of adult severe open-globe injured (OGI) eyes. Retrospective chart review of inpatients with initial visual acuity (VA) of light perception (LP) or no light perception (NLP) associated with OGI between 2017 and 2020 at Department of Ophthalmology, Henan Eye Institute, Henan Eye Hospital, Henan provincial People's Hospital. Six hundred twenty-five eyes of 622 adult patients with initial VA of LP or NLP associated with open-globe injuries (OGIs) were included. The mean age was 47.8 ± 14.1 years with the range from 18 to 91 years. Significant male predominance was noted (81.5%). The most common type of these severe OGIs was rupture (65.8%). Traffic accidents accounted for 13.5% followed by fall/tumble (10.9%) and nail/wire (10.9%) of all the severe OGIs. Almost half of the injuries happened at workplace (47.2%). Initially, 78.7% eyes just received primary debridement and wound closure, while 8.5% eyes with no possible of anatomical reconstruction received evisceration. After initial management, 350 eyes received subsequent operation, including 239 eyes underwent vitrectomy + silicone oil/(+cataract remove). Finally, over 6 months follow-up, 137 eyes (21.9%) were eviscerated, 150 eyes (24.0%) got atrophied, while 132 eyes (21.1%) retain some VA. Fifty-three eyes (8.5%) got VA of 0.3-1.5. Severe OGIs are most seen in the young, middle-aged, and male working population and remain a serious public health problem, resulting in significant vision loss or Evisceration of eyes. Effective preventive measures should be taken for the individuals in these groups.

摘要

描述成人严重开放性眼球损伤(OGI)眼睛的特征、治疗及预后。对2017年至2020年河南省人民医院河南眼科研究所、河南眼科医院眼科住院的初始视力为光感(LP)或无光感(NLP)且伴有OGI的患者进行回顾性病历审查。纳入622例成人患者的625只初始视力为LP或NLP且伴有开放性眼球损伤(OGI)的眼睛。平均年龄为47.8±14.1岁,范围为18至91岁。男性占显著优势(81.5%)。这些严重OGI最常见的类型是破裂(65.8%)。在所有严重OGI中,交通事故占13.5%,其次是跌倒/滚落(10.9%)和钉子/铁丝伤(10.9%)。几乎一半的损伤发生在工作场所(47.2%)。最初,78.7%的眼睛仅接受了一期清创和伤口缝合,而8.5%无法进行解剖重建的眼睛接受了眼球摘除术。初始治疗后,350只眼睛接受了后续手术,其中239只眼睛进行了玻璃体切除术+硅油填充/(+白内障摘除)。最后,经过6个月以上的随访,137只眼睛(21.9%)被摘除眼球,150只眼睛(24.0%)萎缩,而132只眼睛(21.1%)保留了一定视力。53只眼睛(8.5%)视力为0.3 - 1.5。严重OGI在年轻、中年男性工作人群中最为常见,仍然是一个严重的公共卫生问题,导致严重的视力丧失或眼球摘除。应对这些群体中的个体采取有效的预防措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc06/8578959/e02dca66af85/fmed-08-755158-g0001.jpg

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