A 10-YEAR REVIEW OF OPEN-GLOBE TRAUMA IN ELDERLY PATIENTS AT AN URBAN HOSPITAL
A 10-YEAR REVIEW OF OPEN-GLOBE TRAUMA IN ELDERLY PATIENTS AT AN URBAN HOSPITAL
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DOI：
10.1097/iae.0000000000000261
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发表时间：
2015-01-01
影响因子：
3.3
通讯作者：
Bhagat, Neelakshi
中科院分区：
文献类型：
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作者：
Sheng, Iris;Bauza, Alain;Bhagat, Neelakshi
背景资料：描述老年患者开放性眼球损伤（OGI）的人口统计学、特征和结局。方法：回顾性病历回顾。结果：确定了90例（26例男性）。平均年龄为80岁（范围：65-96岁）。OGI的类型包括破裂伤（83.3%）和穿透伤（16.7%）。致伤原因为福尔斯（64.4%）、意外（20%）、机动车事故（5.5%）和殴打（3.33%）。撕裂伤类型包括角膜（44.4%）、角巩膜（26.7%）和巩膜（28.9%）。其中46例为既往眼部手术伤口裂开引起的OGI。10只眼同时发生眼眶骨折。大约81.1%的病例在损伤后24小时内接受了一期OGI修复术，所有病例均在入院后24小时内接受了一期OGI修复术。就诊时的平均视力为20/4，375（SD，0.64）。虽然22例患者表现为无光感，但仅10例在OGI修复后仍无光感。并发症包括葡萄膜脱垂（70%）、出血性脉络膜脱离（37.8%）、玻璃体出血（51.1%）、视网膜脱离（20%）和瞳孔传入缺陷（42.2%）。3例（3.33%）因视网膜脱离和玻璃体积血行一期睫状体平坦部玻璃体切除术。3例患者发生眼内炎。总的来说，在所有接受原发性睫状体平坦部玻璃体切除术的眼睛中实现了视网膜附着。4例（4.44%）无法挽救的无光感eyes.Conclusion：OGI在老年人群中的视力预后差，只有14.4%达到20/200或更好的视力。应采取预防措施预防老年人群的OGI。
Background: To describe the demographics, characteristics, and outcomes of open-globe injuries (OGIs) in elderly patients.Methods: Retrospective chart review.Results: Ninety cases (26 men) were identified. The average age was 80 years (range, 65-96 years). The types of OGIs included rupture (83.3%) and penetrating (16.7%) injuries. The causes of trauma were falls (64.4%), accidents (20%), motor vehicle accidents (5.5%), and assault (3.33%). Types of lacerations included corneal (44.4%), corneoscleral (26.7%), and scleral (28.9%). Forty-six cases were OGIs because of dehiscence of previous ocular surgical wound. Ten eyes had concurrent orbital fractures. Approximately 81.1% of cases underwent primary OGI repair within 24 hours of injury, and all cases underwent primary OGI repair within 24 hours of admission. The average visual acuity at presentation was 20/4,375 (SD, 0.64). Although 22 patients presented with no light perception, only 10 remained no light perception after OGI repair. Complications at presentation included uveal prolapse (70%), hemorrhagic choroidal detachment (37.8%), vitreous hemorrhage (51.1%), retinal detachment (20%), and afferent pupillary defect (42.2%). Three patients (3.33%) underwent primary pars plana vitrectomy for retinal detachment and vitreous hemorrhage. Three patients developed endophthalmitis. Overall, retinal attachment was achieved in all eyes that underwent primary pars plana vitrectomy. Primary enucleations were performed in 4 cases (4.44%) for nonsalvageable no light perception eyes.Conclusion: The visual prognosis of OGIs in the elderly population is poor; only 14.4% achieved 20/200 or better visual acuity. Precautionary measures should be taken to prevent OGIs in the elderly population.