目的:描述带有穿孔的受伤眼球的解剖和视觉结果,并制定射孔眼的预后指标。
方法:案例系列研究,来自多中心前瞻性队列数据库。至12月31日,2018年,选择了63个射孔地球仪。所有病例均接受玻璃体视网膜手术或摘除术,并随访至少6个月。人口特征,受创伤眼睛的基本检查,和眼内组织损伤通过主要手术记录。在后续访问中,最佳校正VA,眼内压,眼内填塞材料,眼球的视网膜解剖结果,和phthisis或摘除进行了评估。
结果:50只眼睛(79%)是由尖锐物体造成的,13只眼睛(21%)是由导弹造成的。通过玻璃体视网膜手术,可以在解剖学上恢复22只受伤的眼睛,最终视力超过4/200。PVR-C(OR=5.67,P=0.01),视网膜切除面积大于视盘2倍(OR=5.16,P=0.04),黄斑损害(OR=6.38,P=0.01)与不良结局相关。
结论:玻璃体视网膜手术可以挽救穿孔的受伤眼睛,PVR-C,视盘的视网膜切除术超过2次,黄斑损伤是长期预后不良的独立危险因素。
OBJECTIVE: To delineate anatomic and visual outcomes of injured eye globes with perforating, and to develop the prognostic indicators for perforating eyes.
METHODS: The case series
study, from a multicenter prospective cohort database. To the date of December 31st, 2018, of 63 perforating globes were selected. All cases underwent vitreoretinal surgeries or enucleations, and were followed up for at least 6 months. Demographic characteristics, basic examination for traumatized eyes, and intraocular tissue damages were recorded by surgery-in-chief. At the follow-up visit, best corrected VA, intraocular pressure, the intraocular tamponade material, retinal anatomic outcome of eye-globes, and phthisis or enucleation were evaluated.
RESULTS: Fifty injured eyes (79%) were caused by sharp objects and 13 eyes (21%) were injured by a missiles. Twenty-two injured eyes can be anatomically restored with final vision of more than 4/200 through vitreoretinal surgery. The PVR-C (OR = 5.67, P = 0.01), area of
retinectomy more than 2 times of optic disk (OR = 5.16, P = 0.04), and macular damage (OR = 6.38, P = 0.01) were correlated with unfavorable outcomes.
CONCLUSIONS: The injured eyes with perforation can be saved through vitreoretinal surgery, the PVR-C,
retinectomy more than 2 times of optic disk, and macular damage were independent risk factors for poor long-term prognosis.