Academy for Eye Care Education, Kallam Anji Reddy Campus, LV Prasad Eye Institute, Hyderabad, India.
Anant Bajaj Retina Institute, Kallam Anji Reddy Campus, LV Prasad eye Institute, Hyderabad, India.
Eye (Lond). 2024 Feb;38(2):297-302. doi: 10.1038/s41433-023-02679-6. Epub 2023 Aug 2.
To report the clinical settings and factors predicting outcomes in scleral tears with concurrent retained intraocular foreign bodies METHODS: All cases with scleral and corneoscleral wounds with retained intraocular foreign bodies (RIOFB) from January 2014 to January 2021 were retrospectively analysed. Favourable anatomic outcome was defined as presence of globe integrity, attached retina, absence of hypotony and active inflammation at last visit. Favourable functional outcome was defined as final visual acuity (VA) > 20/200.
Total 139 eyes were included. Mean age was 30.66 ± 13.32 years (median 29 years, IQR 17). Penetrating trauma accounted for 87.1%, rupture for 5.8%, perforation for 7.2%. In 5.8% of the eyes the injury involved zone I extending till Zone II while in 66.9% it involved Zone II and in 27.3% in Zone III. Snellen visual acuity at presentation was logMAR 2.97 ± 1.01 and at last visit was logMAR 2.38 ± 1.45 (p < 0.0001). Time between presentation and repair was 13.93 ± 19.56 h (median 7.6 h, IQR 17.17). Favourable functional outcome was seen in 34.5% eyes and 2/3rd achieved favourable anatomic outcome. Absence of endophthalmitis (OR = 6.25, p = 0.003) and ability to remove the foreign body (OR = 7.05, p = 0.003) were associated with a favourable anatomic outcome. Better presenting Snellen visual acuity (OR = 2.77, p = 0.003), manifest scleral tear (OR = 3.36, p = 0.04), and absence of endophthalmitis (OR = 50, p = 0.0009) were associated with a favourable functional outcome.
A third of the cases achieved favourable visual outcome while 2/3rd achieved favourable anatomic outcome. Absence of endophthalmitis is an important factor predicting both.
报告伴有眼内异物残留的巩膜裂伤的临床情况和预测结果的因素。
回顾性分析 2014 年 1 月至 2021 年 1 月所有伴有巩膜和角巩膜伤口及眼内异物（RIOFB）的病例。良好的解剖学结果定义为眼球完整、视网膜附着、无低眼压和最后一次就诊时无活动性炎症。良好的功能结果定义为最终视力（VA）>20/200。
共纳入 139 只眼。平均年龄为 30.66±13.32 岁（中位数 29 岁，IQR 17）。穿透性外伤占 87.1%，破裂伤占 5.8%，穿孔伤占 7.2%。5.8%的眼损伤累及Ⅰ区，直至Ⅱ区，66.9%的眼损伤累及Ⅱ区，27.3%的眼损伤累及Ⅲ区。就诊时的 Snellen 视力为 logMAR 2.97±1.01，最后一次就诊时为 logMAR 2.38±1.45（p<0.0001）。就诊至修复的时间为 13.93±19.56 h（中位数 7.6 h，IQR 17.17）。34.5%的眼功能结果良好，2/3 的眼解剖结果良好。无眼内炎（OR=6.25，p=0.003）和能够取出异物（OR=7.05，p=0.003）与良好的解剖学结果相关。更好的就诊时 Snellen 视力（OR=2.77，p=0.003）、明显的巩膜撕裂（OR=3.36，p=0.04）和无眼内炎（OR=50，p=0.0009）与良好的功能结果相关。
三分之一的病例视力结果良好，三分之二的病例解剖学结果良好。无眼内炎是预测两者的重要因素。
