Konno Ami, Ishibazawa Akihiro, Kagokawa Hiroyuki, Meya Yuuki, Nagaoka Taiji
The Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Japan.
Okhotsk Eye Clinic, Asahikawa, Japan.
Am J Ophthalmol Case Rep. 2024 Nov 9;36:102210. doi: 10.1016/j.ajoc.2024.102210. eCollection 2024 Dec.
To document a case of open-globe injury (OGI) caused by a brown bear attack that resulted in a favorable structural and visual outcome.
A 40-year-old Japanese female was transported by ambulance due to OGI with a choroidal hemorrhage in the right eye, resulting in light perception (LP) visual acuity following a brown bear attack. We pursued a two-stage approach, commencing with primary posterior scleral wound repair and an encircling scleral buckle. On postoperative day 17, the patient underwent drainage of the choroidal hemorrhage and pars plana vitrectomy combined with cataract surgery. After the vitreoretinal surgery, visual acuity improved from LP to 20/60.
OGIs may result in severe visual impairment, and in the worst case, enucleation. We hypothesize that primary encircling scleral buckle and vitreoretinal surgery in a two-stage approach are factors contributing to a favorable structural and visual outcome. There are no reports of good visual acuity following a brown bear attack. Preoperative surgical planning and appropriate intraoperative re-assessment are crucial.
记录一例由棕熊袭击导致的开放性眼球损伤（OGI）病例，该病例获得了良好的结构和视觉预后。
一名40岁的日本女性因开放性眼球损伤并伴有右眼脉络膜出血，在被棕熊袭击后导致光感（LP）视力，由救护车送至医院。我们采用了两阶段治疗方法，首先进行原发性后巩膜伤口修复和环扎巩膜扣带术。术后第17天，患者接受了脉络膜出血引流、玻璃体切割联合白内障手术。玻璃体视网膜手术后，视力从光感提高到20/60。
开放性眼球损伤可能导致严重的视力损害，在最坏的情况下会导致眼球摘除。我们推测，两阶段进行原发性环扎巩膜扣带术和玻璃体视网膜手术是获得良好结构和视觉预后的因素。目前尚无棕熊袭击后视力良好的报道。术前手术规划和适当的术中重新评估至关重要。
