Chou Brian W, Feng Shu, Ding Leona, Mudumbai Raghu C
Department of Ophthalmology, University of Washington, Seattle, WA, USA.
Indian J Ophthalmol. 2025 Jan 1;73(1):59-63. doi: 10.4103/IJO.IJO_986_24. Epub 2024 Dec 23.
To characterize visual outcomes in Zone I and II open globe injuries with lens involvement.
Level 1 Trauma Center Hospital, Seattle WA.
Retrospective case series.
Zone I and II open globe injuries between May 2009 and May 2018 were reviewed for lens involvement, demographic data, injury characteristics, associated ocular comorbidities, surgical details, and visual outcomes. Eyes with nontraumatic or surgical injuries, prior penetrating keratoplasty, or a history of cataract extraction were excluded. Visual outcomes were compared using the Kruskal-Wallis and Fisher's exact tests.
A total of 145 Zone I and II globe injuries (63 without lens injury and 82 with lens injury) with at least 6 months of follow-up were included. Endophthalmitis was not identified in any patients without lens involvement, while 9 patients with lens injury (11%) developed endophthalmitis. Patients with lens injury demonstrated a more severe ocular trauma score (P = 0.003). Best-corrected visual acuity (BCVA) was significantly better (P = 0.03) in patients without lens injury compared to those with lens injury. The median (interquartile range) BCVA in the no-lens injury group was 20/40 (20/25 - 20/400), while in the lens injury group it was 20/80 (20/40-20/300). The location of intraocular lens (IOL) placement did not influence final visual acuity outcomes (P = 0.76). However, eyes left aphakic had worse BCVA compared to those that received a secondary IOL (P = 0.005).
Open globe injuries with lens involvement are associated with worse visual prognosis. An increased rate of endophthalmitis may contribute to this difference. In eyes requiring secondary IOL placement, the location of the IOL did not affect final BCVA.
描述伴有晶状体损伤的Ⅰ区和Ⅱ区开放性眼球损伤的视觉预后。
华盛顿州西雅图市一级创伤中心医院。
回顾性病例系列研究。
对2009年5月至2018年5月期间的Ⅰ区和Ⅱ区开放性眼球损伤进行回顾，分析晶状体损伤情况、人口统计学数据、损伤特征、相关眼部合并症、手术细节及视觉预后。排除有非创伤性或手术性损伤、既往穿透性角膜移植术或白内障摘除史的眼睛。采用Kruskal-Wallis检验和Fisher精确检验比较视觉预后。
共纳入145例Ⅰ区和Ⅱ区眼球损伤患者（63例无晶状体损伤，82例有晶状体损伤），随访时间至少6个月。无晶状体损伤的患者均未发生眼内炎，而9例有晶状体损伤的患者（11%）发生了眼内炎。有晶状体损伤的患者眼外伤评分更高（P = 0.003）。与有晶状体损伤的患者相比，无晶状体损伤的患者最佳矫正视力（BCVA）明显更好（P = 0.03）。无晶状体损伤组的BCVA中位数（四分位间距）为20/40（20/25 - 20/400），而有晶状体损伤组为20/80（20/40 - 20/300）。人工晶状体（IOL）植入位置不影响最终视力预后（P = 0.76）。然而，未植入晶状体的眼睛BCVA比接受二期IOL植入的眼睛更差（P = 0.005）。
伴有晶状体损伤的开放性眼球损伤与较差的视觉预后相关。眼内炎发生率增加可能导致了这种差异。在需要二期IOL植入的眼睛中，IOL植入位置不影响最终BCVA。
