东南沿海地区战士LASIK术后眼外伤的调查统计分析

目的:调查东南沿海地区战士LASIK术后眼外伤的原因、LASIK术后时间、伤后来诊时间、伤情及伤后视力,分析视力恢复预后与LASIK术后时间、伤后来诊时间、致伤原因及致伤物的关系。方法:收集2000-01/2006-12门诊战士人数7179例,其中LASIK术后眼外伤患者22例(22眼),18～21岁,男19例(19眼),女3例(3眼),均为单眼受伤。详细记录LASIK术后发生眼部外伤后的致伤原因、致伤物、来诊时间、伤情、视力受损情况,总结视力预后与LASIK术后时间、来诊时间、致伤物及致伤原因的关系。结果:(1)致伤因素:体育运动中受伤:3眼,占13.7%;训练受伤5眼,占22.7%;劳动致伤9眼,占40.9%;其它:5眼,占22.7%,以训练受伤和劳动致伤最常见占63.6%,其中锐器致伤明显重于钝器伤。(2)伤后来诊时间:受伤后3d内来诊最常见,占77.3%。(3)LASIK术后时间:LASIK术后6mo以内16眼,占72.7%;7～12mo4眼,占18.2%:12mo以上2眼,占9.1%。LASIK术后6mo以内最常见,而且术后6mo以内受伤者出现角膜瓣移位或错位最常见,伤情明显重于术后6mo以上的患者。(4)受伤原因与伤情:角膜瓣移位或错位16眼,占72.7%,仅角膜上皮剥脱4眼,占18.2%.同时伴有角膜瓣下异物、瞳孔散大、前房积血、暂时性的眼压升高,留下不可逆性的外伤性瞳孑L散大等12眼,占54.5%。劳动或训练中受伤的视力明显低于其它原因致伤的视力,伤情也明显重于其它原因致伤者。(5)伤情与预后:训练受伤和劳动致伤最常见,伤情最重,预后最差。结论:军人LASIK术后眼外伤的主要原因为训练和劳动中受伤,LASIK术后6mo以内最常见。眼部症状中角膜瓣相关并发症最多见,眼部受伤程度与预后密切相关。提示:LASIK术后病情稳定后再入伍,LASIK术后战士更要特别注意眼睛防护。

Investigation of eye injuries after LASIK in some troops along the south-east coast

AIM; To investigate the causes of eye injuries, consulting-time, extent of wound and outcomes of visual acuity after LASIK in some troops along the south-east coast. And to analyze the relationship among the causes of trauma and visual acuity and post-LASIK periods. METHODS; From 2000 and 2006, 22 post-LASIK patients, aged from 18-21 years old, suffered eye-injury were treated in our hospital. And there were 7179 out-patient-soldiers in the same period. We recorded in detail the causes,consulting-time,characteristics,the extent of wound, treatment measures,and outcomes of visual acuity. RESULTS: (1) Injury causes; the eye trauma commonly resulted from sports (3 eyes, 13.7%) physical labor (9 eyes, 40.9%), training materials (5 eyes, 22.7%), and other causes (5 eyes, 22. 7%). Of them, the sharp objects were more dangerous than blunt assault to eyes. (2) Consulting-time after injury: three-day consulting was most common (77. 3%). (3) The post-LASIK periods: there were 16 eyes (72.7%) within 6 months, 4 eyes (18.2%) within 7-12 months, and 2 eyes (9. 1%) over 12 months. Short period within 6 months after LASIK was most common. The complication was usually flap dislocation and eye condition was more severe than other period. (4) Eye conditions; sixteen eyes (72. 7%) occurred corneal flap dislocation, of them, 12 eyes (54.5%) accompanied by hyphema or underflap foreign bodies or dilated pupil or temporal high intraocular pressure, etc. Eye conditions resulted from sharp objects were more severe than blunt assault. (5) Prognosis and eye conditions: outcomes of visual acuity in physicallabor and training groups were the worst. CONCLUSION; Eye injuries occur most commonly during physical labor and training. Sharp object is more dangerous than blunt assault. The high risk period is within 6 months post-LASIK. Corneal flap dislocation is usually happen. After LASIK, soldiers should pay close attention to their eye protection and put prevention first in Army.