机械性眼外伤300例视力预后多因素分析

目的:通过对我院300例住院治疗的机械性眼外伤患者病历资料进行统计与回顾性分析,探讨机械性眼外伤患者急诊处理后的视力预后影响因素。方法:对300例机械性眼外伤患者的一般情况、眼别、受伤原因、急诊处理方式、入院视力、出院视力等进行记录和统计分析。结果:机械性眼外伤300例,男女比例约为8∶1,15～20岁年龄段男女比例最高,约为14∶1,发病高峰年龄在35～45岁和5～10岁。以眼球开放性外伤、眼和附属器挫伤最多见。在眼球开放性外伤中,以异物伤最多见。致伤原因以钝器伤、锐器伤为主,爆炸伤等原因较为少见。机械性眼外伤300例311眼的治疗方式中以眼内异物取出为主,其次为保守治疗,视力预后的主要影响因素是:致伤原因、是否伤后24h内处理。急诊等处理后,出院视力的提高具有显著性(P<0.05)。结论:机械性眼外伤300例致伤原因以钝器伤、锐器伤和爆炸伤最为常见。住院治疗的机械性眼外伤视力预后的主要影响因素是:致伤原因、是否伤后24h内急诊处理。     

四川乐山市人民医院738例住院眼外伤分析

目的 分析5年间住院眼外伤患者的相关因素。方法 回顾性统计5年间住院眼外伤患者资料。分别逐年比较分析眼外伤所占比例、性别、年龄、眼别、外伤后就诊时间、外伤类型、致伤物、并发症、治疗前后视力等情况。结果 5年来住院眼外伤738例（764只眼）占眼科住院总人数的6．45％,眼外伤所占比例逐年降低。男女之比为4．31：1,左右眼比例相近,受伤年龄段主要为41～60岁,其次为19～40岁。外伤后就诊时间在1d以内者占62．74％。主要致伤物为钝器,其次为锐器及爆炸物。主要外伤类型：眼挫伤占38．64％,角巩膜穿孔伤占17．17％,角膜穿孔伤占11．87％。以前房积血、晶状体脱位、继发性青光眼、外伤性白内障和玻璃体积血为主要并发症。治疗前盲目占68．97％,治疗后盲目占45．15％。眼球摘除61眼,占7．98％。结论 建议加强眼外伤预防知识宣传,做好预防工作,及时有效救治,提高眼外伤一期和二期诊治水平,以降低致盲率。     

眼球破裂伤相关因素分析

目的 观察眼球破裂伤的致伤原因、常见部位、视力预后。方法 眼科住院眼球破裂伤51例的回顾性总结分析。结果 眼球破裂伤的首要致伤因素是打架斗殴(占43％)、其次工伤(占20％)、家庭休闲和旅游误伤(占17％)，交通事故(10％)，其他(10％)。眼球破裂伤的常见部位是上方角膜缘(占45％)，颞侧、鼻侧角膜缘和肌止点后巩膜(各占15％)。经过治疗，Ⅰ度破裂伤7／13获得0．02以上视力，Ⅱ度破裂伤9／20保留光感以上视力，Ⅲ度破裂伤1／18保留光感视力。结论 打架斗殴是眼球破裂伤首要致伤因素，常见伤口位置是上方角膜缘，眼球破裂伤的预后和损伤程度密切相关。     

儿童眼外伤2298例的回顾性分析

目的:对2016～2020年在湖南省儿童医院眼科就诊的眼外伤患儿的病例资料进行分析总结,为儿童眼外伤的预防和治疗提供理论依据。方法:回顾性分析2016-01/2020-12在湖南省儿童医院眼科门急诊及住院治疗的眼外伤患儿2 298例2 332眼的临床资料,对患儿性别、年龄、受伤眼别、就诊时间、致伤月份、致伤原因、受伤部位、眼外伤类型、并发症、治疗方法和视力进行分析。结果:眼外伤患儿年龄主要集中在>3～6岁,占患儿总数的44.26%,其中男1 718例1 745眼,女580例587眼,男女比例为2.96∶1.00。2月份和11月份是儿童眼外伤的高发期。撞伤和摔伤是其主要的致病原因,占40.95%;其次为钝物击伤及锐器伤,共占40.82%。眼外伤患儿受伤部位主要在眼睑等眼附属器,占65.40%。患儿受伤后采取清创、包眼或局部点眼药等保守治疗方式占58.62%,行清创缝合术患儿占38.38%,复杂性眼内手术占3.00%。大多数患儿难以配合检查视力,在完成视力检查的患儿中,眼外伤影响患儿视力者占60.60%,治疗后患儿视力均有不同程度的好转。严重影响视力主要集中在角膜挫裂伤、外伤性白内障...     

青海地区426例眼外伤回顾分析

目的 通过对眼外伤相关资料及致伤因素的回顾性分析,为眼外伤的预防方向和重点提供依据.方法 对我院收治的426例(442眼)眼外伤进行统计分析.结果 伤者以21～50岁的青壮年居多(273眼,占61.76%),男性大于女性(4.59:1);致伤因素以金属碎屑、石块碎屑、玻璃及木棍致伤居首位(48.12%),其次为拳脚击伤、爆炸伤及车祸(35.21%)等;受伤部位以角膜穿孔伤、巩膜裂伤居前位(89.20%).结论 眼外伤是眼科住院患者的常见病和多发病,后果严重.应加强预防.对眼外伤要及时有效的处理.降低眼外伤的并发症.     

苏州市开放性眼外伤的临床分析

目的 调查研究苏州市成人开放性眼外伤的病因及视力结果 .方法 收集2007年1月至2010年7月苏州大学附属第一医院眼科住院收治的成人开放性眼外伤220例(221眼)的临床资料,进行回顾性分析.结果 发病年龄以青壮年居多,平均年龄(41.15±15.39)岁,男女比例为4.37∶1.右眼占55.66％,左眼占44.34％,右眼:左眼=1.26∶1.职业以工人和农民为主.开放性眼外伤以眼球破裂最多(59.55％),以下依次为眼球穿孔伤、眼内异物.未见眼球贯通伤.致伤因素依次为:锐器弹伤、打架或撞伤、摔伤、车祸、鞭炮炸伤、剪刀戳伤等.手术后盲目(视力＜0.05)率为27.73％,眼球摘除率为1.82％.结论 工作和生产意外是成人开放性眼外伤的主要因素,后果严重,应加强预防.及时就诊和眼科显微技术的广泛开展是挽救视力、降低眼外伤并发症的有效保证.     

开放性眼外伤82例临床特征及影响视力的相关因素分析

目的 观察82例开放性眼外伤的流行病学及临床特征,验证眼外伤伤情判断系统的主要指标对82例开放性眼外伤术后视力的预测效果.方法 回顾82例开放性眼外伤住院手术患者资料;记录患者的年龄、性别、受伤初始视力、受伤的类型、伤口的情况及术后最佳矫正视力.将术后视力＜0.1作为预后差的标准,并且与视力≥0.1组相比较,分析两组患者在损伤的类型、伤口分区、初始视力分级等方面的差异.结果 82例开放性眼外伤男女比例为4.41∶1,年龄集中在20 ～50岁,首位致伤器物为金属器具;最后视力≥0.1者42例,占总人数的51.22％;其中视力≥0.5者16例,占总数的19.51％;无光感及眼内炎者各1例;无行眼球摘除术者.视力＜0.1组与视力≥0.1组间的伤口分区、初始视力分级差异有统计学意义(P=0.027,P =0.025),而两组间受伤的类型差异无统计学意义(P=0.270).结论 国际眼外伤小组制定的伤情判断系统对开放性眼外伤的视力预后具有良好的预测作用.     

儿童眼外伤的危险因素分析

目的:研究儿童眼外伤外起视功能损害特别是严重视功能损害的危险因素,同时也对它们的发病原因作了初步的分析。方法:回顾从1989年1月至1992年12月到中山眼科中心的487名15岁及以下的儿童眼外伤患者,采用逐步回归方法分析视力预后与各种潜在危险因素的关系(年龄、性别、受伤时间、外伤类型、致伤原因等)。结果:男女比例为3:1。儿童眼外伤会造成严重的视功能损害,特别是在男性4～6岁年龄段。65％病例的最后记录视力在0.3或以上,但19％在0.05以下。多因素分析表明外伤类型与预后视力显著相关,视力预后=0.963775-0.0896543×外伤类型。结论:儿童眼外伤可导致严重的视功能损害,特别是在男性4～8岁年龄段。视力预后与外伤类型显著相关。眼科学报1997;13:177—181。     

巴州地区开放性眼外伤137例流行病学特征及临床分析

目的：回顾性分析137例138眼开放性眼外伤患者的流行病学特征及现代眼科显微技术对眼外伤预后视力的效果观察。

方法：回顾137例138眼开放性眼外伤住院患者临床资料; 记录受伤原因、时间、地点与就诊时间、致伤物种类、受伤分级及并发症情况及手术方式、治疗前后视力。将视力<0.1作为预后差的标准与视力≥0.1组进行比较。分析治疗前后视力差异。

结果：开放性眼外伤137例男女比例为6.61：1,以19～49岁青壮年为多,平均年龄33.28岁。致伤物第一位为金属器物,第二位为木质; 90例90眼接受二期手术处理,占65.2%,其中有34例34眼接受全玻璃体切割手术,术后6mo最佳矫正视力≥0.5者有31例31眼,占22.5%,最佳矫正视力≥0.1者77例77眼,占55.8%。治疗前后视力构成比差异有统计学意义,治疗后视力得到显著改善(χ²=137.40,P=0.000)。1例双眼雷管爆炸伤患者1眼给予行眼球摘除。

结论：经济欠发达地区开放性眼外伤与国际眼外伤流行病学特征相符,又有自已的特征,积极的眼外伤一期处理和二期全玻璃体切割手术能有效提高患者术后最佳矫正视力,减少并发症,改善眼外伤患者伤后生活质量。     

高原眼外伤发病情况的探讨

目的探讨高原眼外伤的特点,以便更好的防治。方法对7个月间住院的闭合性和开放性眼外伤107例,进行回顾性临床分析。结果高原眼外伤发生率高,眼外伤占同期住院总例数的50．95％;外伤伤情严重,治疗前视力低于0．05者占66．67％。致伤原因有其特殊性：就诊时间晚,最晚者伤后10d,平均（30．36±4．66）h;年龄偏小,平均年龄（30．80±1．33）岁,年龄最小者仅9个月;治疗后果差,治疗后视力低于0．05者仍占43．14％。结论应加强高原地区眼外伤防护知识及医疗技术支持。     

Pattern of ocular injuries in stone pelters in Kashmir valley

PurposeTo describe the pattern and types of ocular injuries in stone pelters in Kashmir valley during recent turmoil.DesignCross sectional study.MethodsSixty patients with different types of eye injuries were assessed between June–September 2010 and initial visual acuity was recorded. The injuries were classified according to Systems for Classifying Ocular Injuries (OTCS) and Ocular Trauma Score (OTS) was calculated in order to estimate the probability of follow-up visual acuity range.ResultsMost of the victims (75%) were young boys between 16–26 years with a mean age of 20.95, 95% of cases were males. The main cause of injury was stones (48.3%) and pellets (30%) besides rubber bullets, sling shots and tear gas shells.Most of the open-globe injuries due to stones were of Type B and A, Grade E, Zone II and III with Afferent Pupillary Defect (APD) in 30% of the cases. Closed-globe injuries were mostly of Type A, Grade C and D and Zone II and III.Most of the open-globe injuries due to pellets were of Type D, Grade D, Zone II and APD in 33.3%. Pellets Intra Ocular Foreign Body (IOFB) was in 41.6%. Most of the closed-globe injuries were of Type A, Grade D and E and of Zone III.Overall OTS of 1 was calculated in 16.6% and 3 in 53.3% of the cases.ConclusionIn stone pelting demonstrations eye injuries can result in visually significant trauma. Injuries due to pellets are mostly perforating and pellet IOFB, and both tend to have a very poor prognosis. OTS can be used to estimate visual prognosis.     

系统救治复杂开放性眼外伤的临床体会

目的：分析复杂开放性眼外伤救治过程中各阶段手术的特点，强调伤眼救治的时序性。方法：对我院1998年1月～2002年1月间收治的开放性眼外伤二期进行玻璃体切割手术的56例(58眼)进行回顾性分析。结果：伤眼经二期玻璃体手术后，最终视力提高44眼(75．9％)，视力保持不变9眼(15．5％)，视力下降5眼(8．6％)；伤眼一期伤口修复满意的视力预后明显好于不满意的；伤后2周左右实施玻切手术的视力预后明显好于其他时间段，伤后超过1月进行玻切的伤眼视力预后最差。结论：复杂开放性眼外伤显微手术的一期修复水平决定着伤眼的命运，准确把握二期玻璃体切割手术时机，使外伤眼的救治具有系统性，对伤眼的预后至关重要。     

Hospitalized eye injury in a large industrial city of South-Eastern Asia

Backgrounds Wearing appropriate eye-protection devices in workplace, sports and motorcycling have not been a routine in most of Asian countries. The purpose of this study is to assess the frequency, causes, mechanisms, functional outcomes and costs of hospitalized eye injuries in a large industrial city in South Eastern Asia. Methods A retrospective review of the hospital admission files of ocular trauma admitted to the Kaohsiung Medical University Hospital from January 2001 to December 2002. Results One hundred and sixty cases of eye injuries were identified for study. Male patients (83.1%) were significantly more than female, while in the work-related group, male was predominant with 92.2%. Work-related injuries accounted for 48.1% (77 cases) with a mean age of 42.3 years, older than the 36.0 years mean for the non-work-related group. The most common cause of hospitalized injury was contusion injury (49.4%), while in the work-related group it was open-globe trauma (34.0%). Hyphema of anterior chamber (23.1%) was the most common diagnosis, followed by vitreous hemorrhage (15.6%) and corneal perforation (13.8%). In work-related injuries, lid and corneal lacerations were the most common. The visual prognosis was poor in injured eyes, with 39.6% eyes having final best corrected visual acuity less than 0.1, and it was even worse at 43.8% in work-related group. The most frequent (46.8%) durations of hospital stay were from 3 to 5 days. The mean cost of eye injuries per case in the work-related group was 1382 US dollars, significantly more than the 909 US dollars per case for the non-work-related group. Conclusion The hospitalized ocular injuries incurred significant visual loss, health-care expenses and socio-economic impacts. Safety strategies aimed at preventing eye injury are mandatory.     

Vision-limiting complications in open-globe injuries

BACKGROUND: To correlate vision-limiting complications of open-globe trauma with anatomical zone and mechanism of injury. METHODS: Retrospective review of 235 patients with open-globe injuries at the Massachusetts Eye and Ear Infirmary. Vision-limiting complications were assessed at 2 to 3 months after the injury. RESULTS: Traumatic cataracts and corneal scarring were the most prevalent vision-limiting complications in patients with zone I (cornea-only) lacerations. The most common vision-limiting factors in eyes with zones II and III lacerations (involving sclera) were cataracts and retinal detachments. In patients with penetrating injuries, predominant vision-limiting findings were traumatic cataracts and corneal scarring. In patients with blunt-force ruptures, leading causes were traumatic cataracts and retinal detachments. There were increased rates of phthisis and enucleation surgery in patients with ruptures and zones II and III injuries. In cases of penetrating and zone I injuries, significantly more patients achieved visual acuities better than 20/50 when compared with eyes that had ruptures or zones II and III injuries. INTERPRETATION: Traumatic cataracts were the most common vision-limiting factor in all subcategories of open-globe injuries. Injuries in zones II and III and blunt-force ruptures were associated with increased rates of retinal detachments, phthisis, and enucleation, contributing to the poorer visual prognosis in these patients.     

Epidemiology of open- and closed-globe trauma presenting to Cairns Base Hospital, Queensland

PURPOSE: To review the epidemiology of serious ocular trauma presenting to Cairns Base Hospital, from the far north Queensland health districts. METHODS: A retrospective study of cases from January 1995 to November 2002 inclusive. Cases were analysed with respect to demographics, cause and nature of injury, method of transport and time to and type of ophthalmic treatment, and visual outcomes. RESULTS: There were 226 cases identified, including 71 open-globe and 155 closed-globe injuries. The annual rate of injury was 3.7 per 100 000 for open-globe and 11.8 per 100 000 in total. The Aboriginal and Torres Strait Islander population from the far north Queensland districts showed a disproportionate incidence, with 38% of the total number of injuries, despite representing only 12.3% of the population. Assault in the Aboriginal and Torres Strait Islander population resulted in 69.6% of injuries in men and 75.8% of injuries in women. Of all assaults 76.2% were alcohol-related. The majority (71.5%) of injuries in the Caucasian population were due to accidental blunt and sharp trauma. In total, 77.4% of injuries occurred in men, with an average age of 31 years. Of all open and closed injuries in the study, a final visual acuity of 6/12 or better was achieved in 47.8% of eyes and a final visual acuity of 6/60 or less occurred in 17.7% of patients, 20.8% patients were lost to follow up. In total, 14.1% of open injuries required enucleation/evisceration. CONCLUSIONS: The incidence of ocular trauma in far north Queensland is equal to other Australian populations. However, there is a disproportionately high incidence in the Aboriginal and Torres Strait Islander population. Alcohol-related assault is a significant cause of visual loss in the Aboriginal and Torres Strait Islander population. Closed-globe injuries are more common than open globe; however, the latter have poorer visual prognosis. Initial visual acuity of all injuries correlated with final visual acuity.     

Pediatric traumatic cataract and surgery outcomes in eastern China:a hospital-based study

AIM: To evaluate the etiologies, management, and outcomes of pediatric traumatic cataract in eastern China.METHODS:Pediatric traumatic cataract were reviewed for demographic information, type of injury, mode of injury, time of injury, interval between injury and first visiting doctors, hospital of first visiting, surgeries, complications and prognosis.RESULTS:A total of 117 eyes of 117 patients (96 boys and 21 girls) with unilateral injuries (66 right and 51 left eyes) were included in the study. The mean (SEM) age at diagnosis was (6.6±3.2) years (range, 1.3-13.8 years). Each cataract was categorized according to the type of trauma:closed-globe (n=26) or open-globe (n=91) injuries. The most common injuring objects were sharp metal objects (37.61%). The most common complication in open-globe injuries was corneal laceration, whereas traumatic mydriasis was most common in closed-globe injuries. Of 68 eyes in patients with open-globe injuries who received cataract extraction, intraocular lens (IOLs) were primarily implanted in 47 eyes (68.12%), whereas 18 eyes with closed-globe injuries received cataract extraction, and IOLs were primarily implanted in 17 eyes (94.4%). The surgical procedures included reconstruction of the anterior segment, synechiolysis, excision of the membrane, lensectomy, vitrectomy and related techniques. Postoperative vision was significantly improved compared with preoperative vision.CONCLUSION: Pediatric traumatic cataract should be treated in time to attenuate the complications, and education on pediatric traumatic cataract and improvements in pediatric health care are needed for the early detection of cataract in children.     

Hospitalized eye injury in a Chinese urban population:a 7-year retrospective analysis

AIM:To present the epidemiology,cause of injury,ocular status and final visual acuity after management of severe ocular trauma required hospitalization during 7 years in a representative urban Chinese population. METHODS:A retrospective analysis of the hospital admission files of ocular trauma patients admitted to the Daping hospital from January 2000 to December 2006 was carried out. RESULTS:A total of 268 patients were open-globe injury and the remaining 294 patients were closed-globe types.The most common causes of ocular injuries were metal(29.4%), explosive(14.6%)and stone(13.9%).And the visual outcomes of most of eye injury patients in this study were poor;half of injured eyes ended with visual acuity worse than 0.1. CONCLUSION:Therapeutic methods to ocular trauma make a great progress in recent years,but the visual outcomes are poor.