Alfaro D V, Chaudhry N A, Walonker A F, Runyan T, Saito Y, Liggett P E
Uniformed Services University of the Health Sciences, Bethesda, Maryland 120814-4799.
Retina. 1994;14(3):201-5. doi: 10.1097/00006982-199414030-00003.
Penetrating eye injuries remain an important cause of blindness among children.
Thirty consecutive children, nine years of age or younger, were treated for penetrating eye injuries. Twenty-two (73%) of those patients studied were male and 8 (17%) were female. The average age of the patients was 4.6 years. Sharp objects accounted for the majority of injuries (83%). Twenty (66%) eyes required only primary repair and 10 (33%) eyes required secondary lensectomy and vitreous surgery, which was done within 10 days of the primary repair. Length of follow-up ranged from 6 months to 48 months, and 5 patients were lost to follow-up.
Visual acuity of 20/40 or better was achieved in 13 (72%) of the 18 patients requiring only primary repair. Stereopsis was present in 13 (87%) of these patients. Of those patients that underwent secondary lensectomy with anterior or pars plana vitrectomy, 42% had visual acuity of 20/100 or better. None had stereopsis.
Young children with penetrating eye injuries requiring only primary repair may achieve excellent visual recovery, whereas those with traumatic cataract necessitating lensectomy and vitreous surgery have a less favorable outcome because of more severe injury and subsequent amblyopia.
穿透性眼外伤仍是儿童失明的重要原因。
连续收治30例9岁及以下的穿透性眼外伤患儿。其中22例(73%)为男性,8例(17%)为女性。患儿的平均年龄为4.6岁。锐器伤占大多数(83%)。20只眼(66%)仅需一期修复,10只眼(33%)需二期晶状体切除联合玻璃体手术,该手术在一期修复后10天内完成。随访时间为6个月至48个月,5例患者失访。
仅需一期修复的18例患者中,13例(72%)视力达到20/40或更好。其中13例(87%)有立体视。在接受二期晶状体切除联合前部或睫状体平坦部玻璃体切除术的患者中,42%的患者视力达到20/100或更好。无一例有立体视。
仅需一期修复的穿透性眼外伤幼儿可能实现极佳的视力恢复,而因创伤性白内障需要进行晶状体切除联合玻璃体手术的患儿,由于损伤更严重及随后发生弱视,预后较差。