Prognostic Indicators for No Light Perception After Open-Globe Injury: Eye Injury Vitrectomy Study
Prognostic Indicators for No Light Perception After Open-Globe Injury: Eye Injury Vitrectomy Study
复制标题
DOI：
10.1016/j.ajo.2011.04.004
复制
发表时间：
2011-10-01
影响因子：
4.2
通讯作者：
Ma, Zhizhong
中科院分区：
文献类型：
--
作者：
Feng, Kang;Hu, Yun Tao;Ma, Zhizhong
目的：描述眼外伤后无光感（NLP）的眼部特征、手术干预、解剖和视觉结果，并探讨眼外伤后无光感病例的预后预测因素。设计：介入病例系列研究。方法：从眼损伤玻璃体切除研究数据库中选择33只创伤性NLP眼，这是一项基于医院的多中心前瞻性队列研究。纳入标准是开放性球损伤后的NLP病例，结果为解剖恢复，结节或去核。排除标准为记录缺失、伤后在非参与医院行玻璃体切除术、直接视头损伤、眼内炎、低斜视或硅油持续眼。所有病例在探查术后均行玻璃体视网膜手术或眼球摘除术，随访至少6个月。评估了两种结果：有利结果（解剖恢复的眼球具有光感知[LP]或更好的视力）和不利结果（NLP，球状结核或去核）。结果：两组间有显著性差异的危险因素有：破裂（P = 0.021）；开放型球形III型（P = 0.046）；巩膜创面>= 10 mm (P = 0.001)；纤毛体损伤（P < 0.001）；严重眼内出血（P = 0.005）；闭合性漏斗型视网膜脱离或视网膜脱垂（P = 0.005）；脉络膜损伤（P = 0.001）。结论：这7种危险因素可能是不良预后的预测因素。如果尝试玻璃体视网膜手术，创伤性NLP的眼睛可以在解剖上恢复LP或更好的视力，并且通过减少这些危险因素的数量来增加良好的解剖和视力结果。[J]中华眼科杂志，2011;32(2):654-662。(C)爱思唯尔公司2011。版权所有。)
PURPOSE: To describe ocular characteristics, surgical interventions, and anatomic and visual outcomes of traumatized eyes with no light perception (NLP) following open-globe injury and to investigate prognostic predictors for NLP cases after open-globe injury.DESIGN: Interventional case series study.METHODS: Thirty-three traumatized eyes with NLP were selected from the Eye Injury Vitrectomy Study database, a hospital-based multicenter prospective cohort study. Inclusion criteria were NLP cases following open-globe injury with outcomes of anatomic restoration, phthisis bulbi, or enucleation. Exclusion criteria were cases with missing records, undergoing vitrectomy after injury at nonparticipating hospitals, direct optic head injury, endophthalmitis, and hypotonous or silicone oil-sustained eyes. All cases underwent vitreoretinal surgery or enucleation after exploratory surgery and were followed up for at least 6 months. Two outcomes were assessed: favorable outcome (anatomically restored eye globes with light perception [LP] or better vision) and unfavorable outcome (NLP, phthisis bulbi, or enucleation).RESULTS: The following 7 risk factors were significant between the 2 groups: rupture (P = .021); open globe III (P = .046); scleral wound >= 10 mm (P = .001); ciliary body damage (P < .001); severe intraocular hemorrhage (P = .005); closed funnel retinal detachment or retinal prolapse (P = .005); and choroidal damage (P =.001).CONCLUSIONS: These 7 risk factors are possible predictors of poor prognosis. Traumatized eyes with NLP can be anatomically restored with LP or better vision if vitreoretinal surgery is attempted, and a favorable anatomic and visual outcome is increased by having a decreased number of these risk factors. (Am J Ophthalmol 2011;152:654-662. (C) 2011 by Elsevier Inc. All rights reserved.)