AIM:To evaluate the predictive value of pediatric penetrating ocular trauma score(POTS)on the visual outcome in children with open globe injury.METHODS:A retrospective study in 90 children(60 males and 30 females)aged...AIM:To evaluate the predictive value of pediatric penetrating ocular trauma score(POTS)on the visual outcome in children with open globe injury.METHODS:A retrospective study in 90 children(60 males and 30 females)aged 1-15 y(average,7.48±2.86 y)with penetrating ocular trauma was performed.Each patient’s POTS was calculated.The effects of POTS on final visual acuity(FVA)were examined.Correlation between factors affecting POTS and the FVA was established.RESULTS:All patients presented with single-eye trauma.The follow-up time was 3-21 mo(average,10.23±3.54 mo).Among the 90 cases of penetrating wounds,71 eyes(78.89%)were injured in Zone I(wound involvement limited to the cornea,including the corneoscleral limbus),17 eyes(18.89%)were injured in Zone II(wound involving the sclera and no more posterior than 5 mm from the corneoscleral limbus),and 2 eyes(2.22%)were injured in Zone III(wound involvement posterior to the anterior 5 mm of the sclera).Analysis of POTS and FVA showed important correlation between them(r=0.414,P=0.000).Initial visual acuity(P=0.00),age(P=0.02),injury location(P=0.002),traumatic cataract(P=0.00),vitreous hemorrhage(P=0.027),retinal detachment(P=0.003),and endophthalmitis(P=0.03)were found to be statistically significant factors for the FVA outcome.CONCLUSION:Ocular trauma presents serious consequences and poor prognosis in children.The POTS may be a reliable prognostic tool in children with open globe injury.展开更多
AIM: To elucidate the question of whether the ocular trauma score(OTS) and the zones of injury could be used as a predictive model of traumatic and post traumatic retinal detachment(RD) in patients with open globe inj...AIM: To elucidate the question of whether the ocular trauma score(OTS) and the zones of injury could be used as a predictive model of traumatic and post traumatic retinal detachment(RD) in patients with open globe injury(OGI).METHODS: A retrospective observational chart analysis of OGI patients was performed. The collected variables consisted of age, date, gender, time of injury, time until repair, mechanism of injury, zone of injury, injury associated vitreous hemorrhage, trauma associated RD, post traumatic RD, aphakia at injury, periocular trauma and OTS in cases of OGI. RESULTS: Totally 102 patients with traumatic OGI with a minimum of 12 mo follow-up and a median age at of 48.6 y(range: 3-104 y) were identified. Final best corrected visual acuity(BCVA) was independent from the time of repair, yet a statistically significant difference was present between the final BCVA and the zone of injury. Severe trauma presenting with an OTS score Ⅰ(P<0.0001) or Ⅱ(P<0.0001) revealed a significantly worse BCVA at last follow up when compared to the cohort with an OTS score >Ⅲ. OGI associated RD was observed in 36/102 patients(35.3%), whereas post traumatic RD(defined as RD following 14 d after OGI) occurred in 37 patients(36.3%). OGI associated RD did not correlate with the OTS and the zone of injury(P=0.193), yet post traumatic RD correlated significantly with zone Ⅲ injuries(P=0.013). CONCLUSION: The study shows a significant association between lower OTS score and zone Ⅲ injury with lower final BCVA and a higher number of surgeries, but only zone Ⅲ could be significantly associated with a higher rate of RD.展开更多
AIM: To evaluate the predictive value and applicability of Ocular Trauma Score(OTS) and Pediatric Ocular Trauma Score(POTS) for closed and open globe injuries in the pediatric group.METHODS: A retrospective study of c...AIM: To evaluate the predictive value and applicability of Ocular Trauma Score(OTS) and Pediatric Ocular Trauma Score(POTS) for closed and open globe injuries in the pediatric group.METHODS: A retrospective study of closed and open globe injuries in children age of 0-18-year-old between 2012-2019 was conducted.Medical records were collected,and injuries were classified using Birmingham Eye Trauma Terminology System(BETTS).The predictive value and applicability of both OTS and POTS to final visual acuity(VA) were analyzed.RESULTS: Of 84 patients,59(70.2%) presented with closed globe injuries(CGI) and 25(29.8%) with open globe injuries(OGI).The mean of initial VA was 0.832±0.904 log MAR.OTS and POTS was calculated.Initial VA(P<0.001) and traumatic cataract(P<0.001) were significantly associated with visual outcome,followed by organic/unclean wound (P=0.001),delay of surger y(P=0.001),iris prolapse(P=0.003),and globe rupture(P=0.008).A strong correlation between OTS and POTS and final VA(r=-0.798,P<0.001;r=-0.612,P<0.001) was found.OTS was more applicable in all age group of pediatric and in contrast to POTS,it was designed for 0-15 years old.POTS requires eleven parameters and OTS six parameters.Even though initial VA was not available,we could still calculate into POTS equation.CONCLUSION: OTS and POTS are highly predictive prognostic tools for final VA in CGI and OGI's in children.展开更多
AIM: To complete the data of ocular trauma in central China, as a well-known tertiary referral center for ocular trauma, we documented the epidemiological characteristics and visual outcomes of patients hospitalized f...AIM: To complete the data of ocular trauma in central China, as a well-known tertiary referral center for ocular trauma, we documented the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in this region.METHODS: A retrospective study of patients hospitalized for ocular trauma in central China from 2006 to 2011 was performed.· RESULTS: This study included 5964 eyes of 5799 patients. The average age was 35.5 ±21.8y with a male-to-female ratio of 2.8:1. The most common age was 45-59 y age group. Most patients were farmers and workers(51.9%). The most common injuries were firework related(24.5%), road traffic related(24.2%), and work related(15.0%). Among the most common causative agents were firecrackers(24.5%), followed by metal/knife/scissors(21.4%). Most injuries occurred in January(14.2%),February(27.0%), and August(10.0%). There were 8.5%patients with ocular injuries combined with other injuries.The incidence of open ocular injuries(4585 eyes, 76.9%)was higher than closed ocular injuries(939 eyes, 15.7%).The incidences of chemical and thermal ocular injuries were 1.2% and 0.6%. Ocular trauma score(OTS)predicted final visual acuity at non light perception(NLP), 20/200-20/50 and 20/40 with a sensitivity of 100%,and light perception(LP) /hand motion(HM) and 1/200-19/200 with a specificity of 100%.· CONCLUSION: This study provides recent epidemiological data of patients hospitalized for ocular trauma in central China. Some factors influencing the visual outcome include time interval between injury and visit to the clinic, wound location, open or closed globe injury, initial visual acuity, and OTS.展开更多
AIM: To determine the visual outcomes in adult patients who sustained open globe injuries and to determine whether the visual prognosis following an eye injury in an African setting differs from the predicted outcomes...AIM: To determine the visual outcomes in adult patients who sustained open globe injuries and to determine whether the visual prognosis following an eye injury in an African setting differs from the predicted outcomes according to the Ocular Trauma Score(OTS)study. A secondary aim was to establish the evisceration rate for these injuries and assess how this form of intervention affected outcomes in comparison to the OTS.·METHODS: A prospective case series of all patients admitted with open globe injuries over a two-year(July2009 to June 2011) period. Injuries were scored using the OTS and the surgical intervention was recorded. The best corrected visual acuity at three months was regarded as visual outcome.· RESULTS: There were 249 open globe injuries, of which 169 patients(169 eyes) completed the 3-month follow-up. All patients underwent primary surgery, 175(70.3%) repairs, 61(24.5%) eviscerations and 13(5.2%)other procedures. Globe eviscerations were mainly done on OTS Category 1 cases, but outcomes in this category were not found to be different from OTS outcomes.Outcomes were significantly worse in Category 2, but when the entire distribution was tested, the differences were not statistically significant. The overall association between OTS outcomes and the final visual outcomes in this study was found to be a strong(P <0.005).· CONCLUSION: Reliable information regarding the expected outcomes of eye injuries will influence management decisions and patient expectations. The OTS is a valuable tool, the use of which has been validated in many parts of the world-it may also be a valid predictor in an African setting.展开更多
Traumatic cataract resulting from open- or closed-globe ocular trauma is one of the most common causes of blindness. Visual outcome is unpredictable because this is not determined solely by the lens. There is a lack o...Traumatic cataract resulting from open- or closed-globe ocular trauma is one of the most common causes of blindness. Visual outcome is unpredictable because this is not determined solely by the lens. There is a lack of a standard classification, investigations, and treatment guidelines related to the outcome, with considerable debate regarding predictive models. We review the predictors of visual outcome following surgical treatment of traumatic cataracts, which may act as a guide to clinicians.展开更多
Purpose:Open globe eye injuries can have profound social and economic consequences. Here, we describe two cases of war and outdoor activity open globe eye injury where, despite a low OTS score,.current microsurgical t...Purpose:Open globe eye injuries can have profound social and economic consequences. Here, we describe two cases of war and outdoor activity open globe eye injury where, despite a low OTS score,.current microsurgical technology allowed for a favorable outcome.Case report 1: A 33-year-old Libyan soldier had been treated for an open-globe grenade blast trauma to his left eye, which showed light perception and OTS score 2..He had undergone a lensectomy and PPV with silicone oil tamponade. Surgical treatment included scleral buckling,.cornea trephination, temporary Eckardt keratoprosthesis, PPV revision, intraocular lens(IOL) implantation, and corneal grafting. Six months later, his VA was improved to 20 / 70.Case report 2:.A 35-year-old man presented with a corneal laceration in his left eye from a meat skewer,.with marked hypotony and LP..After primary corneal wound closure,.Bscan ultrasonography revealed massive vitreous hemorrhage(OTS score 2). The patient underwent open cataract extraction with IOL implantation, 23 gauge PPV, laser photocoagulation of the retinochoroidal laceration, and a gas tamponade. After three weeks,.the patient underwent a 2nd 23 G PPV due to a fibrinous reaction. Six month later, the patients exhibited 20 /25 VA.Conclusion:.These cases confirm that even for patients with a low OTS and poor visual prognosis,.an up-to-date surgery protocol may achieve visual results adequate for leading an autonomous daily life.展开更多
<strong>Purpose of Review:</strong> The management of eye injuries is both difficult and argumentative. This study attempts to highlight the management of ocular trauma using currently available informatio...<strong>Purpose of Review:</strong> The management of eye injuries is both difficult and argumentative. This study attempts to highlight the management of ocular trauma using currently available information in the literature and author experience. This review presents a workable framework from the first presentation, epidemiology, classification, investigations, management principles, complications, prognostic factors, final visual outcome and management debates. <strong>Review Findings:</strong> Mechanical ocular trauma is a leading cause of monocular blindness and possible handicap worldwide. Among several classification systems, the most widely accepted is Birmingham Eye Trauma Terminology (BETT). Mechanical ocular trauma is a topic of unsolved controversy. Patching for corneal abrasion, paracentesis for hyphema, the timing of cataract surgery and intraocular lens implantation are all issues in anterior segment injuries. Regarding posterior segment controversies, the timing of vitrectomy, use of prophylactic cryotherapy, the necessity of intravitreal antibiotics in the absence of infection, the use of vitrectomy vs vitreous tap in traumatic endophthalmitis is the issues. The pediatric age group needs to be approached by a different protocol due to the risk of amblyopia, intraocular inflammation, and significant vitreoretinal adhesions. The various prognostic factors have a role in the final visual outcome. B scan is used to exclude R.D, Intraocular foreign body (IOFB), and vitreous haemorrhage in hazy media. Individual surgical strategies are used for every patient according to the classification and extent of the injuries. <strong>Conclusion:</strong> This article examines relevant evidence on the management challenges and controversies of mechanical trauma of the eye and offers treatment recommendations based on published research and the authors’ own experience.展开更多
AIM: To review results of traumatic cataracts in children.METHODS: Only those pediatric patients who fitted in the definite inclusion criteria were considered for study enrollment. They were further examined for any k...AIM: To review results of traumatic cataracts in children.METHODS: Only those pediatric patients who fitted in the definite inclusion criteria were considered for study enrollment. They were further examined for any kind of co-morbidities because of trauma, operated upon for traumatic cataracts with intraocular lens implantation. Amblyopia if present was treated. All were re-examined at the culmination of six-week postoperative period.According to the Birmingham Eye Trauma Terminology System the traumatic cataract cases were divided into group 1(open globe) and group 2(closed globe), and then determinants of visual acuity were compared.RESULTS: There were 544 eyes in group 1 and 127 eyes in group 2 in our study of 671 eyes with pediatric traumatic cataracts. Visual acuity at the end of 6 wk after surgery in the operated eye was > 6/60 in 450(82.7%) and ≥ 6/12 in 215(39.4%) eyes in the open globe group and > 20/200 in 127(81.8%) and ≥ 6/12 in 36(28.4%) eyes in the closed globe group(P = 0.143), and the difference between the groups was not significant in children. Overall, 402(39.4%) eyes gained ≥ 6/60 and > 5/12 in 238(35.4%) cases. Surgical treatment caused a significant difference in visual outcome(P = 0.000). When we compared achieved visual outcome with ocular trauma score predicted vision, no significant difference was found.CONCLUSION: Traumatic cataracts in children may have better outcome and ocular trauma score is a useful predictive method for the ocular trauma in children.展开更多
背景战场上眼战伤发生率较高,复杂眼战伤应给予准确评估并及时处置,为下一步后送治疗提供准确信息和手术依据,因此探索眼战伤的紧急救治对于提升部队作战能力有重要意义。目的探讨标准化沟通模式SBAR[Situation(现状)-Background(背景)-...背景战场上眼战伤发生率较高,复杂眼战伤应给予准确评估并及时处置,为下一步后送治疗提供准确信息和手术依据,因此探索眼战伤的紧急救治对于提升部队作战能力有重要意义。目的探讨标准化沟通模式SBAR[Situation(现状)-Background(背景)-Assessment(评估)-Recommendation(建议)]联合眼创伤评分系统(ocular trauma score,OTS)建立的标准化模板,在野战医疗所对眼战伤进行标准化分级,是否能给救治过程提供客观准确的信息,指导制定更为合理的救治和后送方案。方法我院野战医疗所在驻训演练过程中联合应用SBAR沟通模式和OTS评分系统,设计适合我院野战医疗所检伤救治流程规范的模板,通过检伤组自评和救治组互评的方式,对比模板应用前后救治主动性、救治时效性、救治准确性、交接流畅性、信息完整性、工作满意度等情况。结果应用SBAR眼外伤检伤标准模板后检伤分类组自评救治主动性(84.53±4.52 vs 78.87±5.00)、救治时效性(86.80±4.089 vs 82.00±4.068)、救治准确性(87.60±4.215 vs 83.37±4.311)、病历信息与收容救治组交接时的流畅性(89.20±4.06 vs 83.97±4.77)、信息完整性(90.00±4.39 vs 83.23±4.61)、工作满意度(91.50±3.93 vs 85.90±4.41)均优于使用前,差异有统计学意义(P均<0.05)。结论SBAR沟通模式联合OTS评分应用于野战医疗所眼部损伤的伤员救治,能够优化救治流程,提高医护人员满意度,值得推广。展开更多
AIM:To investigate the patterns and outcomes of open globe injuries in the elderly population in Iran.METHODS:In this retrospective cross-sectional chart review,medical records of 248 patients(aged 60 y and more)with ...AIM:To investigate the patterns and outcomes of open globe injuries in the elderly population in Iran.METHODS:In this retrospective cross-sectional chart review,medical records of 248 patients(aged 60 y and more)with the diagnosis of open globe injury from 2006 to 2016 were reviewed.Demographic features,type,and mechanism of open globe injury,ocular trauma score(OTS),visual acuity before and after treatment,the zone of injuries,and the associated injuries found at the presentation or thereafter were documented.RESULTS:A total of 248 eyes of 248 patients were included.The mean age was 69.2±5.8 y(range:60-90 y).Male/female ratio was about 3:1(187 vs 61).The three most common causes of injury were falling(25.2%),sharp objects(18.9%),and tree branches(13.9%).Penetrating injury accounted for most of the geriatric ocular trauma(50.4%),followed by globe rupture(40.3%),intraocular foreign body(IOFB;7.3%),and perforating injury(2.0%).The median raw OTS for the population was 60.5 and the most common OTS class was 3.The injuries tend to affect zoneⅠmore than zoneⅡand zoneⅢ.The only predictor of final visual acuity was the class of OTS(P<0.001).CONCLUSION:Geriatric open globe injury should be valued specifically.The most common type of open globe injury in Iran is penetrating injuries but falling remain the main cause.The OTS class must be considered as an important predictor of final visual acuity.展开更多
文摘AIM:To evaluate the predictive value of pediatric penetrating ocular trauma score(POTS)on the visual outcome in children with open globe injury.METHODS:A retrospective study in 90 children(60 males and 30 females)aged 1-15 y(average,7.48±2.86 y)with penetrating ocular trauma was performed.Each patient’s POTS was calculated.The effects of POTS on final visual acuity(FVA)were examined.Correlation between factors affecting POTS and the FVA was established.RESULTS:All patients presented with single-eye trauma.The follow-up time was 3-21 mo(average,10.23±3.54 mo).Among the 90 cases of penetrating wounds,71 eyes(78.89%)were injured in Zone I(wound involvement limited to the cornea,including the corneoscleral limbus),17 eyes(18.89%)were injured in Zone II(wound involving the sclera and no more posterior than 5 mm from the corneoscleral limbus),and 2 eyes(2.22%)were injured in Zone III(wound involvement posterior to the anterior 5 mm of the sclera).Analysis of POTS and FVA showed important correlation between them(r=0.414,P=0.000).Initial visual acuity(P=0.00),age(P=0.02),injury location(P=0.002),traumatic cataract(P=0.00),vitreous hemorrhage(P=0.027),retinal detachment(P=0.003),and endophthalmitis(P=0.03)were found to be statistically significant factors for the FVA outcome.CONCLUSION:Ocular trauma presents serious consequences and poor prognosis in children.The POTS may be a reliable prognostic tool in children with open globe injury.
文摘AIM: To elucidate the question of whether the ocular trauma score(OTS) and the zones of injury could be used as a predictive model of traumatic and post traumatic retinal detachment(RD) in patients with open globe injury(OGI).METHODS: A retrospective observational chart analysis of OGI patients was performed. The collected variables consisted of age, date, gender, time of injury, time until repair, mechanism of injury, zone of injury, injury associated vitreous hemorrhage, trauma associated RD, post traumatic RD, aphakia at injury, periocular trauma and OTS in cases of OGI. RESULTS: Totally 102 patients with traumatic OGI with a minimum of 12 mo follow-up and a median age at of 48.6 y(range: 3-104 y) were identified. Final best corrected visual acuity(BCVA) was independent from the time of repair, yet a statistically significant difference was present between the final BCVA and the zone of injury. Severe trauma presenting with an OTS score Ⅰ(P<0.0001) or Ⅱ(P<0.0001) revealed a significantly worse BCVA at last follow up when compared to the cohort with an OTS score >Ⅲ. OGI associated RD was observed in 36/102 patients(35.3%), whereas post traumatic RD(defined as RD following 14 d after OGI) occurred in 37 patients(36.3%). OGI associated RD did not correlate with the OTS and the zone of injury(P=0.193), yet post traumatic RD correlated significantly with zone Ⅲ injuries(P=0.013). CONCLUSION: The study shows a significant association between lower OTS score and zone Ⅲ injury with lower final BCVA and a higher number of surgeries, but only zone Ⅲ could be significantly associated with a higher rate of RD.
文摘AIM: To evaluate the predictive value and applicability of Ocular Trauma Score(OTS) and Pediatric Ocular Trauma Score(POTS) for closed and open globe injuries in the pediatric group.METHODS: A retrospective study of closed and open globe injuries in children age of 0-18-year-old between 2012-2019 was conducted.Medical records were collected,and injuries were classified using Birmingham Eye Trauma Terminology System(BETTS).The predictive value and applicability of both OTS and POTS to final visual acuity(VA) were analyzed.RESULTS: Of 84 patients,59(70.2%) presented with closed globe injuries(CGI) and 25(29.8%) with open globe injuries(OGI).The mean of initial VA was 0.832±0.904 log MAR.OTS and POTS was calculated.Initial VA(P<0.001) and traumatic cataract(P<0.001) were significantly associated with visual outcome,followed by organic/unclean wound (P=0.001),delay of surger y(P=0.001),iris prolapse(P=0.003),and globe rupture(P=0.008).A strong correlation between OTS and POTS and final VA(r=-0.798,P<0.001;r=-0.612,P<0.001) was found.OTS was more applicable in all age group of pediatric and in contrast to POTS,it was designed for 0-15 years old.POTS requires eleven parameters and OTS six parameters.Even though initial VA was not available,we could still calculate into POTS equation.CONCLUSION: OTS and POTS are highly predictive prognostic tools for final VA in CGI and OGI's in children.
基金Supported by National Key Basic Research Program of China(973 Program)(No.2013CB967001)National Natural Science Foundation of China(31271400)+3 种基金Medical Science and Technology Research Project of Henan Province,China(No.201203021)2014 Annual Science and Technology Key Project of Education Department of Henan Province(No.14A320085)the Team Construction and Innovative Research of the First Affiliated Hospital of Zhengzhou University of 2011Youth Innovation Foundation of the First Affiliated Hospital of Zhengzhou University of 2011
文摘AIM: To complete the data of ocular trauma in central China, as a well-known tertiary referral center for ocular trauma, we documented the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in this region.METHODS: A retrospective study of patients hospitalized for ocular trauma in central China from 2006 to 2011 was performed.· RESULTS: This study included 5964 eyes of 5799 patients. The average age was 35.5 ±21.8y with a male-to-female ratio of 2.8:1. The most common age was 45-59 y age group. Most patients were farmers and workers(51.9%). The most common injuries were firework related(24.5%), road traffic related(24.2%), and work related(15.0%). Among the most common causative agents were firecrackers(24.5%), followed by metal/knife/scissors(21.4%). Most injuries occurred in January(14.2%),February(27.0%), and August(10.0%). There were 8.5%patients with ocular injuries combined with other injuries.The incidence of open ocular injuries(4585 eyes, 76.9%)was higher than closed ocular injuries(939 eyes, 15.7%).The incidences of chemical and thermal ocular injuries were 1.2% and 0.6%. Ocular trauma score(OTS)predicted final visual acuity at non light perception(NLP), 20/200-20/50 and 20/40 with a sensitivity of 100%,and light perception(LP) /hand motion(HM) and 1/200-19/200 with a specificity of 100%.· CONCLUSION: This study provides recent epidemiological data of patients hospitalized for ocular trauma in central China. Some factors influencing the visual outcome include time interval between injury and visit to the clinic, wound location, open or closed globe injury, initial visual acuity, and OTS.
文摘AIM: To determine the visual outcomes in adult patients who sustained open globe injuries and to determine whether the visual prognosis following an eye injury in an African setting differs from the predicted outcomes according to the Ocular Trauma Score(OTS)study. A secondary aim was to establish the evisceration rate for these injuries and assess how this form of intervention affected outcomes in comparison to the OTS.·METHODS: A prospective case series of all patients admitted with open globe injuries over a two-year(July2009 to June 2011) period. Injuries were scored using the OTS and the surgical intervention was recorded. The best corrected visual acuity at three months was regarded as visual outcome.· RESULTS: There were 249 open globe injuries, of which 169 patients(169 eyes) completed the 3-month follow-up. All patients underwent primary surgery, 175(70.3%) repairs, 61(24.5%) eviscerations and 13(5.2%)other procedures. Globe eviscerations were mainly done on OTS Category 1 cases, but outcomes in this category were not found to be different from OTS outcomes.Outcomes were significantly worse in Category 2, but when the entire distribution was tested, the differences were not statistically significant. The overall association between OTS outcomes and the final visual outcomes in this study was found to be a strong(P <0.005).· CONCLUSION: Reliable information regarding the expected outcomes of eye injuries will influence management decisions and patient expectations. The OTS is a valuable tool, the use of which has been validated in many parts of the world-it may also be a valid predictor in an African setting.
文摘Traumatic cataract resulting from open- or closed-globe ocular trauma is one of the most common causes of blindness. Visual outcome is unpredictable because this is not determined solely by the lens. There is a lack of a standard classification, investigations, and treatment guidelines related to the outcome, with considerable debate regarding predictive models. We review the predictors of visual outcome following surgical treatment of traumatic cataracts, which may act as a guide to clinicians.
文摘Purpose:Open globe eye injuries can have profound social and economic consequences. Here, we describe two cases of war and outdoor activity open globe eye injury where, despite a low OTS score,.current microsurgical technology allowed for a favorable outcome.Case report 1: A 33-year-old Libyan soldier had been treated for an open-globe grenade blast trauma to his left eye, which showed light perception and OTS score 2..He had undergone a lensectomy and PPV with silicone oil tamponade. Surgical treatment included scleral buckling,.cornea trephination, temporary Eckardt keratoprosthesis, PPV revision, intraocular lens(IOL) implantation, and corneal grafting. Six months later, his VA was improved to 20 / 70.Case report 2:.A 35-year-old man presented with a corneal laceration in his left eye from a meat skewer,.with marked hypotony and LP..After primary corneal wound closure,.Bscan ultrasonography revealed massive vitreous hemorrhage(OTS score 2). The patient underwent open cataract extraction with IOL implantation, 23 gauge PPV, laser photocoagulation of the retinochoroidal laceration, and a gas tamponade. After three weeks,.the patient underwent a 2nd 23 G PPV due to a fibrinous reaction. Six month later, the patients exhibited 20 /25 VA.Conclusion:.These cases confirm that even for patients with a low OTS and poor visual prognosis,.an up-to-date surgery protocol may achieve visual results adequate for leading an autonomous daily life.
文摘<strong>Purpose of Review:</strong> The management of eye injuries is both difficult and argumentative. This study attempts to highlight the management of ocular trauma using currently available information in the literature and author experience. This review presents a workable framework from the first presentation, epidemiology, classification, investigations, management principles, complications, prognostic factors, final visual outcome and management debates. <strong>Review Findings:</strong> Mechanical ocular trauma is a leading cause of monocular blindness and possible handicap worldwide. Among several classification systems, the most widely accepted is Birmingham Eye Trauma Terminology (BETT). Mechanical ocular trauma is a topic of unsolved controversy. Patching for corneal abrasion, paracentesis for hyphema, the timing of cataract surgery and intraocular lens implantation are all issues in anterior segment injuries. Regarding posterior segment controversies, the timing of vitrectomy, use of prophylactic cryotherapy, the necessity of intravitreal antibiotics in the absence of infection, the use of vitrectomy vs vitreous tap in traumatic endophthalmitis is the issues. The pediatric age group needs to be approached by a different protocol due to the risk of amblyopia, intraocular inflammation, and significant vitreoretinal adhesions. The various prognostic factors have a role in the final visual outcome. B scan is used to exclude R.D, Intraocular foreign body (IOFB), and vitreous haemorrhage in hazy media. Individual surgical strategies are used for every patient according to the classification and extent of the injuries. <strong>Conclusion:</strong> This article examines relevant evidence on the management challenges and controversies of mechanical trauma of the eye and offers treatment recommendations based on published research and the authors’ own experience.
文摘AIM: To review results of traumatic cataracts in children.METHODS: Only those pediatric patients who fitted in the definite inclusion criteria were considered for study enrollment. They were further examined for any kind of co-morbidities because of trauma, operated upon for traumatic cataracts with intraocular lens implantation. Amblyopia if present was treated. All were re-examined at the culmination of six-week postoperative period.According to the Birmingham Eye Trauma Terminology System the traumatic cataract cases were divided into group 1(open globe) and group 2(closed globe), and then determinants of visual acuity were compared.RESULTS: There were 544 eyes in group 1 and 127 eyes in group 2 in our study of 671 eyes with pediatric traumatic cataracts. Visual acuity at the end of 6 wk after surgery in the operated eye was > 6/60 in 450(82.7%) and ≥ 6/12 in 215(39.4%) eyes in the open globe group and > 20/200 in 127(81.8%) and ≥ 6/12 in 36(28.4%) eyes in the closed globe group(P = 0.143), and the difference between the groups was not significant in children. Overall, 402(39.4%) eyes gained ≥ 6/60 and > 5/12 in 238(35.4%) cases. Surgical treatment caused a significant difference in visual outcome(P = 0.000). When we compared achieved visual outcome with ocular trauma score predicted vision, no significant difference was found.CONCLUSION: Traumatic cataracts in children may have better outcome and ocular trauma score is a useful predictive method for the ocular trauma in children.
文摘背景战场上眼战伤发生率较高,复杂眼战伤应给予准确评估并及时处置,为下一步后送治疗提供准确信息和手术依据,因此探索眼战伤的紧急救治对于提升部队作战能力有重要意义。目的探讨标准化沟通模式SBAR[Situation(现状)-Background(背景)-Assessment(评估)-Recommendation(建议)]联合眼创伤评分系统(ocular trauma score,OTS)建立的标准化模板,在野战医疗所对眼战伤进行标准化分级,是否能给救治过程提供客观准确的信息,指导制定更为合理的救治和后送方案。方法我院野战医疗所在驻训演练过程中联合应用SBAR沟通模式和OTS评分系统,设计适合我院野战医疗所检伤救治流程规范的模板,通过检伤组自评和救治组互评的方式,对比模板应用前后救治主动性、救治时效性、救治准确性、交接流畅性、信息完整性、工作满意度等情况。结果应用SBAR眼外伤检伤标准模板后检伤分类组自评救治主动性(84.53±4.52 vs 78.87±5.00)、救治时效性(86.80±4.089 vs 82.00±4.068)、救治准确性(87.60±4.215 vs 83.37±4.311)、病历信息与收容救治组交接时的流畅性(89.20±4.06 vs 83.97±4.77)、信息完整性(90.00±4.39 vs 83.23±4.61)、工作满意度(91.50±3.93 vs 85.90±4.41)均优于使用前,差异有统计学意义(P均<0.05)。结论SBAR沟通模式联合OTS评分应用于野战医疗所眼部损伤的伤员救治,能够优化救治流程,提高医护人员满意度,值得推广。
文摘AIM:To investigate the patterns and outcomes of open globe injuries in the elderly population in Iran.METHODS:In this retrospective cross-sectional chart review,medical records of 248 patients(aged 60 y and more)with the diagnosis of open globe injury from 2006 to 2016 were reviewed.Demographic features,type,and mechanism of open globe injury,ocular trauma score(OTS),visual acuity before and after treatment,the zone of injuries,and the associated injuries found at the presentation or thereafter were documented.RESULTS:A total of 248 eyes of 248 patients were included.The mean age was 69.2±5.8 y(range:60-90 y).Male/female ratio was about 3:1(187 vs 61).The three most common causes of injury were falling(25.2%),sharp objects(18.9%),and tree branches(13.9%).Penetrating injury accounted for most of the geriatric ocular trauma(50.4%),followed by globe rupture(40.3%),intraocular foreign body(IOFB;7.3%),and perforating injury(2.0%).The median raw OTS for the population was 60.5 and the most common OTS class was 3.The injuries tend to affect zoneⅠmore than zoneⅡand zoneⅢ.The only predictor of final visual acuity was the class of OTS(P<0.001).CONCLUSION:Geriatric open globe injury should be valued specifically.The most common type of open globe injury in Iran is penetrating injuries but falling remain the main cause.The OTS class must be considered as an important predictor of final visual acuity.
