Department of Ophthalmology, Atatürk State Hospital, Antalya-Turkey.
Department of Ophthalmology, Gülhane Training and Research Hospital, Ankara-Turkey.
Ulus Travma Acil Cerrahi Derg. 2022 May;28(5):648-653. doi: 10.14744/tjtes.2021.25822.
The study was to report the clinical features and post-operative outcomes in military personnel admitted to the Ocular Trauma Center of Gülhane Training and Research Hospital after sustaining combat injuries in urban warfare.
This is a retrospective, non-comparative, interventional case series analyzing Turkish military personnel transferred to our tertiary ocular trauma center from the warfare zone and combat support hospitals. Ocular injuries were subdivided into zones and ocular trauma classification.
There were 103 combat ocular injuries in 74 military personnel. The average age was 27.31±4.64 years (range; 21-48 years), and all were men (100%). The average follow-up was 529.34±213.98 days (288-1464 days). There were 84 open-globe and 19 closed-globe injuries. Thirty-six (34.9%) had final vision of 20/40 or better. Pars plana vitrectomy was the most common surgery (79.6%). Five eyes underwent evisceration, and seven eyes developed phthisis bulbi. The globe survival rate was 88.3%. Zone III injuries (32.2%) were the most common cause of unfavorable visual outcomes, and most injuries were caused by improvised explosive devices (IEDs) (59.2%). These devices also had the worst impact on globe survival and visual improvement. These eyes had a higher likelihood ratio of requiring globe removal surgery or developing phthisis bulbi [odds ratio: 21.5 (95% CI: 1.23-373)]. Two eyes that underwent keratoprosthesis-assisted pars plana vitrectomy followed by penetrating keratoplasty (PKP) during the same session developed PKP failure while failure was not seen in any of the cases that underwent PKP in a later session.
Ocular injuries related to IEDs had the most significant impact on both visual and anatomic prognoses, and globe survival was less likely in eyes with zone III trauma, in which intraocular foreign bodies penetrated the choroid. There is a higher pos-sibility of PKP failure if this procedure is performed during the same session as other ocular surgery.
本研究旨在报告在城市战争中遭受战斗伤害后被送往古尔哈内培训与研究医院眼外伤中心的军人的临床特征和术后结果。
这是一项回顾性、非对照、干预性病例系列研究，分析了从战区和战斗支援医院转至我们的三级眼外伤中心的土耳其军人。眼外伤分为区和眼外伤分类。
74 名军人中共有 103 例战斗性眼外伤。平均年龄为 27.31±4.64 岁（范围：21-48 岁），均为男性（100%）。平均随访时间为 529.34±213.98 天（288-1464 天）。有 84 例开放性眼球伤和 19 例闭合性眼球伤。36 只眼（34.9%）最终视力达到 20/40 或更好。玻璃体切除术是最常见的手术（79.6%）。5 只眼行眼球摘除术，7 只眼发生眼球萎缩。眼球存活率为 88.3%。区 III 损伤（32.2%）是导致视力不良的最常见原因，大多数损伤是由简易爆炸装置（IED）引起的（59.2%）。这些装置对眼球存活率和视力改善的影响也最严重。这些眼更有可能需要眼球摘除术或发生眼球萎缩[比值比：21.5（95%置信区间：1.23-373）]。2 只眼在同一期行角膜缘切开术辅助玻璃体切除术联合穿透性角膜移植术（PKP）后，行 PKP 术失败，而在随后分期行 PKP 术的病例中未观察到失败。
与 IED 相关的眼外伤对视力和解剖预后的影响最大，区 III 外伤的眼球存活率较低，其中眼内异物穿透脉络膜。如果该手术与其他眼部手术同期进行，PKP 术失败的可能性更高。
