Hospital de Base do Distrito Federal, SMHS - Área Especial, quadra 101, Asa Sul, Brasília, Distrito Federal, Brasília, CEP 70330-150, Brazil.
Centro Universitário de Brasília, Quadra 707/907, Campus Universitário, Asa Norte, Distrito Federal, Brasília, CEP 70790-075, Brazil.
BMC Ophthalmol. 2022 Mar 9;22(1):111. doi: 10.1186/s12886-021-02183-z.
To identify the epidemiological profile and prognostic factors of open globe injuries that require emergency surgical treatment.
Retrospective cohort study.
Patients with OGI who underwent publicly funded emergency surgical treatment in the Federal District from 2014 to 2018.
Data were collected by reviewing electronic medical records through a questionnaire and tabulated. The statistical analysis was performed in SPSS Statistics 26.0.0.0 (p ≤ 0.05).
A total of 359 records were included, corresponding to 336 eyes of 334 patients (294 males and 40 females). The average age was 32.7 years. The affected eye was the right eye in 165 cases, the left eye in 166 cases, and both eyes in 3 cases. The average time between injury and hospitalization was 75.7 h, and the time between injury and surgery averaged 173.7 h. The injury types were as follows: 197 penetrating; 109 rupture; 19 IOFB; 11 perforating. The injuries were in the following zones: 181 zone I; 82 zone II; 70 zone III. The OTS grades were as follows: 57 were classified as grade 1; 101 were grade 2; 142 were grade 3; 28 were grade 4; and 8 were 5. The most commonly performed surgeries were corneal suture, corneoscleral suture, and evisceration. The most common clinical features were traumatic cataract, herniated iris and hyphema. The following were risk factors for poor prognosis: zone III, time between trauma and surgery > 72 h, rupture injury, retinal detachment, disorganization of the eyeball, endophthalmitis, uveal prolapse, OTS classification 1 or 2, and low initial visual acuity. The following factors predicted a good prognosis: initial VA > 1/200, penetrating injury, OTS 4 and zone II.
The high frequency of many of these factors may explain the high rate of severe visual loss found. Injury localization in zone II was identified as a previously unrecognized protective factor against severe visual loss.
确定需要紧急手术治疗的开放性眼球损伤（OGI）的流行病学特征和预后因素。
回顾性队列研究。
2014 年至 2018 年在联邦区接受公共资助紧急手术治疗的 OGI 患者。
通过问卷调查和制表回顾电子病历收集数据。使用 SPSS Statistics 26.0.0.0 进行统计分析（p≤0.05）。
共纳入 359 份记录，共 336 只眼，涉及 334 名患者（294 名男性，40 名女性）。平均年龄为 32.7 岁。患眼为右眼 165 只，左眼 166 只，双眼 3 只。受伤与住院的平均时间为 75.7 小时，受伤与手术的平均时间为 173.7 小时。损伤类型如下：197 例穿透伤；109 例破裂伤；19 例眼内异物伤；11 例穿通伤。损伤部位如下：181 例Ⅰ区；82 例Ⅱ区；70 例Ⅲ区。眼外伤分级（OTS）如下：57 级 1 级；101 级 2 级；142 级 3 级；28 级 4 级；8 级 5 级。最常进行的手术是角膜缝合术、角巩膜缝合术和眼内容剜除术。最常见的临床特征是外伤性白内障、虹膜脱出和前房积血。以下是预后不良的危险因素：Ⅲ区、外伤至手术时间＞72 小时、破裂伤、视网膜脱离、眼球结构紊乱、眼内炎、葡萄膜脱出、OTS 分级 1 或 2、初始视力低。以下因素预测预后良好：初始 VA＞1/200、穿透伤、OTS 4 级和Ⅱ区。
这些因素中的许多因素的高频率可能解释了发现的严重视力丧失的高发生率。Ⅱ区的损伤定位被确定为以前未被认识到的严重视力丧失的保护因素。
