目的：探讨机械性眼外伤分类系统对闭合性眼外伤（ CGI）预后评价的意义。方法连续入选2011年4月至2014年3月住院闭合性眼外伤337例（352只眼），对眼外伤的类型（根据损伤机制）、程度（根据损伤后最初视力）、区域（根据损伤的解剖位...目的：探讨机械性眼外伤分类系统对闭合性眼外伤（ CGI）预后评价的意义。方法连续入选2011年4月至2014年3月住院闭合性眼外伤337例（352只眼），对眼外伤的类型（根据损伤机制）、程度（根据损伤后最初视力）、区域（根据损伤的解剖位置）、相对性瞳孔传入障碍（ RAPD），及其他可能影响预后的因素如前房积血、外伤性白内障、继发性青光眼、视神经挫伤、就诊延迟时间（定义为眼外伤发生后至到医院接受诊治的时间间隔）、是否有医疗或伤害保险、手术次数、住院时间、住院费用等进行单因素及多因素逐步Log istic回归分析，以观察对预后视力的影响。结果病例随访至少6个月，预后好（视力≥0．5）151只眼，占42．90％，预后差（视力＜0．5）201只眼，占57．10％。单因素分析显示：损伤程度（ P ＝0．000）、损伤区域（ P ＝0．000）、RAPD（ P ＝0．000）、前房积血（ P ＝0．000）、外伤性白内障（ P ＝0．001）、继发性青光眼（ P ＝0．004）、视神经挫伤（ P ＝0．000）、住院时间（ P ＝0．000）、手术次数（ P ＝0．000）是影响视力预后的危险因素。而在多因素逐步Log istic回归分析之后显示：损伤程度（ P ＝0．000，OR ＝2．533，95％C I ＝2．050－3．129）、损伤区域（ P ＝0．013，OR ＝1.061，95％C I＝1．012-1．111）及手术次数（ P ＝0．029， OR ＝2．418，95％CI ＝1．096-5．336）是影响预后视力的独立危险因素。结论损伤程度、区域及手术次数是影响CGI视力预后的主要因素。机械性眼外伤分类系统有助于闭合性眼外伤的预后判断。展开更多
BACKGROUNDANDOBJECTIVE: To assess surgical and visual outcomeswith pars plana vitrectomy (PPV) in closed-globe injuries resulting in anterior and posterior segment pathologies and evaluate the factors influencing the ...BACKGROUNDANDOBJECTIVE: To assess surgical and visual outcomeswith pars plana vitrectomy (PPV) in closed-globe injuries resulting in anterior and posterior segment pathologies and evaluate the factors influencing the prognosis. PATIENTS AND METHODS: Retrospective ob servational study. Fortyseven eyes of 47 consecutive patients who underwent PPV because of closed-globe injury between January 1992 and August 2003 were reviewed. Surgical and visual outcomes and prognostic factors were analyzed according to the Ocular Trauma Classification System. RESULTS: Preoperative visual acuity was less than 4/200 in 49%of eyes, classified as grades IV to V After surgery, this ratio was 23%(P < .05)-. Final visual acuity was statistically significantly better in grade I (P=.0001), grade II (P=.002), and relative afferent pupillary defect-negative (P=.0001) injuries. Maculopathy was the most common adverse outcome influencing final visual acuity (32%), followed by secondary glaucoma (13%) and proliferative vitreoretinopathy (8%). CONCLUSION: PPV is a favorable treatment modality in severe closed-globe injuries. Assessment of injuries with respect to the Ocular Trauma Classification System seemed to predict visual outcomes in this series.展开更多
文摘目的：探讨机械性眼外伤分类系统对闭合性眼外伤（ CGI）预后评价的意义。方法连续入选2011年4月至2014年3月住院闭合性眼外伤337例（352只眼），对眼外伤的类型（根据损伤机制）、程度（根据损伤后最初视力）、区域（根据损伤的解剖位置）、相对性瞳孔传入障碍（ RAPD），及其他可能影响预后的因素如前房积血、外伤性白内障、继发性青光眼、视神经挫伤、就诊延迟时间（定义为眼外伤发生后至到医院接受诊治的时间间隔）、是否有医疗或伤害保险、手术次数、住院时间、住院费用等进行单因素及多因素逐步Log istic回归分析，以观察对预后视力的影响。结果病例随访至少6个月，预后好（视力≥0．5）151只眼，占42．90％，预后差（视力＜0．5）201只眼，占57．10％。单因素分析显示：损伤程度（ P ＝0．000）、损伤区域（ P ＝0．000）、RAPD（ P ＝0．000）、前房积血（ P ＝0．000）、外伤性白内障（ P ＝0．001）、继发性青光眼（ P ＝0．004）、视神经挫伤（ P ＝0．000）、住院时间（ P ＝0．000）、手术次数（ P ＝0．000）是影响视力预后的危险因素。而在多因素逐步Log istic回归分析之后显示：损伤程度（ P ＝0．000，OR ＝2．533，95％C I ＝2．050－3．129）、损伤区域（ P ＝0．013，OR ＝1.061，95％C I＝1．012-1．111）及手术次数（ P ＝0．029， OR ＝2．418，95％CI ＝1．096-5．336）是影响预后视力的独立危险因素。结论损伤程度、区域及手术次数是影响CGI视力预后的主要因素。机械性眼外伤分类系统有助于闭合性眼外伤的预后判断。
文摘BACKGROUNDANDOBJECTIVE: To assess surgical and visual outcomeswith pars plana vitrectomy (PPV) in closed-globe injuries resulting in anterior and posterior segment pathologies and evaluate the factors influencing the prognosis. PATIENTS AND METHODS: Retrospective ob servational study. Fortyseven eyes of 47 consecutive patients who underwent PPV because of closed-globe injury between January 1992 and August 2003 were reviewed. Surgical and visual outcomes and prognostic factors were analyzed according to the Ocular Trauma Classification System. RESULTS: Preoperative visual acuity was less than 4/200 in 49%of eyes, classified as grades IV to V After surgery, this ratio was 23%(P < .05)-. Final visual acuity was statistically significantly better in grade I (P=.0001), grade II (P=.002), and relative afferent pupillary defect-negative (P=.0001) injuries. Maculopathy was the most common adverse outcome influencing final visual acuity (32%), followed by secondary glaucoma (13%) and proliferative vitreoretinopathy (8%). CONCLUSION: PPV is a favorable treatment modality in severe closed-globe injuries. Assessment of injuries with respect to the Ocular Trauma Classification System seemed to predict visual outcomes in this series.
