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玻璃体切割术治疗眼内异物后的结局及预后因素——三级医疗中心的11年回顾性分析

Outcomes and Prognostic Factors Following Pars Plana Vitrectomy for Intraocular Foreign Bodies-11-Year Retrospective Analysis in a Tertiary Care Center.

作者信息

Hapca Mădălina Claudia, Muntean George Adrian, Drăgan Iulia Andrada Nemeș, Vesa Ștefan Cristian, Nicoară Simona Delia

机构信息

Doctoral School of Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy, 8, V. Babeș Str., 400012 Cluj-Napoca, Romania.

Department of Ophthalmology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 8, V. Babeș Str., 400012 Cluj-Napoca, Romania.

出版信息

J Clin Med. 2022 Aug 1;11(15):4482. doi: 10.3390/jcm11154482.

Abstract

Aim: To evaluate the visual outcome of penetrating ocular injuries with a retained intraocular foreign body (IOFB) managed by pars plana vitrectomy (PPV) and to describe the risk factors associated with poor visual acuity and retinal detachment (RD) development. Methods: Medical records of 56 patients with IOFB that were removed by PPV over a period of 11 years (1 January 2010−31 December 2020) were reviewed. We extracted the demographic data, initial and final best corrected visual acuity (BCVA) using standard Snellen chart, IOFB characteristics, complications and surgical details. Outcome was evaluated according to the final BCVA: poor <0.1, good 0.1−<0.5 or excellent ≥0.5. Results: The mean age was 36.1 ± 14.1 (range, 16−71) years and the majority of patients were males (55 out of 56, 98.2%). IOFB was retinal in 27 (48.2%) cases and intravitreal in 29 cases (51.8%). IOFB size was ≤3mm in 26 (46.4%) cases and >3mm in 30 (53.6%) cases. Preoperative RD was identified in 12 (21.4%) cases and endophthalmitis in 17 cases (30.4%). IOFBs larger than 3 mm and retinal location were associated with RD development. Poor visual outcome was associated with initial BCVA, retinal location, RD and endophthalmitis. Conclusion: Initial BCVA, retinal foreign body, RD and endophthalmitis were risk factors for poor visual outcome.

摘要

目的

评估经扁平部玻璃体切除术(PPV)治疗的伴有眼内异物(IOFB)残留的穿透性眼外伤的视觉预后,并描述与视力低下和视网膜脱离(RD)发生相关的危险因素。方法:回顾了11年期间(2010年1月1日至2020年12月31日)56例行PPV取出IOFB的患者的病历。我们提取了人口统计学数据、使用标准斯内伦视力表测量的初始和最终最佳矫正视力(BCVA)、IOFB特征、并发症及手术细节。根据最终BCVA评估预后:差<0.1、良好0.1−<0.5或优秀≥0.5。结果:平均年龄为36.1±14.1(范围16−71)岁,大多数患者为男性(56例中的55例,98.2%)。IOFB位于视网膜的有27例(48.2%),位于玻璃体腔的有29例(51.8%)。IOFB大小≤3mm的有26例(46.4%),>3mm的有30例(53.6%)。术前诊断为RD的有12例(21.4%),诊断为眼内炎的有17例(30.4%)。大于3mm的IOFB及视网膜位置与RD发生相关。视觉预后差与初始BCVA、视网膜位置、RD及眼内炎相关。结论:初始BCVA、视网膜异物、RD及眼内炎是视觉预后差的危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2db9/9369935/32bd84711c74/jcm-11-04482-g001.jpg

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