【摘要】 目的：评价分析无晶状体眼II期植入前房型和后房型人工晶状体的效果。进行II期人工晶状体植入的最常见原因是无晶状体眼眼镜矫正不满意或不耐受及不愿意佩戴隐形眼镜。方法：前瞻性，非随机对照实验研究，伊朗亚兹德Sadoughi医院眼科，1995/2005年。根据之前进行的白内障手术的类型，后房型人工晶状体植入62 眼 (60.78%)，前房型人工晶状体植入40 眼 (39.21%)。根据随访期间的病历记录分析患者基本资料和临床资料。结果：患者102例，其中女42例（41.18%），男60例(58.82%)，在1995/2005年期间进行了II期人工晶状体植入术。年龄在48～72（平均62.6）岁，平均随访时间20.2mo（6～72mo）。术中及术后并发症少，手术及拆线后3mo视力状况如下：视力20/20的有48例(47.05%),视力20/40以上的有 51 例(50%), 视力下降 (snellens 视力表中3行) 的有3例 (2.95%)。结论：II期人工晶状体植入术的短期并发症并不比I期白内障摘除并人工晶状体植入多，视力结果与术前最佳矫正视力相同，因此II期人工晶状体植入术可以安全有效的治疗无晶状体眼。
【关键词】 II期人工晶状体；无晶状体眼；复明·Original article·
Clinical analysis of 124 patients with penetrating ocular injuries in Hyderabad Pakistan
Ashok Kumar Narsani, Syed Asher Dabir, Siddiqa Gul, Shafi Muhammad Jatoi, Mahtab
Alam Khanzada, Mahesh Kumar
Department of Ophthalmology, Liaquat University Eye Hospital, Hyderabad, Pakistan
AbstractAIM：To assess the common causes of penetrating ocular injuries and to determine the visual outcome of these cases.
METHODS: A total of one hundred and twenty four eyes of 124 patients suffering from penetrating ocular injury between the ages 660 years, presenting to the Department of Ophthalmology, Liaquat University of Medical and Health Sciences were assessed clinically to determine the common causes of the penetrating intraocular injury and the final visual outcome.
RESULTS: One hundred and twenty four eyes with penetrating ocular injuries were enrolled in the study. The mean age was 35 years, (range 6 to 60 years).Males were predominant 86.3% with most of the patients less than 20 years of age (71%). Occupational class was mostly affected by the intraocular injuries accounting to 76%. 51% patients had best corrected final visual acuity between perception of light to 6/60. Among the 124 patients in whom both initial and final visual acuities were reliably recorded, there was a correlation between poor initial visual acuity and poor final visual acuity.
CONCLUSION: Penetrating eye injury is a common incident, predominantly in young males and often resulting in poor visual outcome in the injured eye. Labour work without protective measures and children playing with hazardous objects are associated with more frequent and severe ocular injuries.
KEYWORDS:penetrating;ocular injuries;visual consequences
Narsani AK, Dabir SA, Gul S, Jatoi SM, Khanzada MA, Kumar M. Clinical analysis of 124 patients with penetrating ocular injuries in Hyderabad Pakistan. Int J Ophthalmol(Guoji Yanke Zazhi)2008;8(11):21642166
INTRODUCTION
Penetrating eye injury is a common preventable cause of visual impairment and vision loss[1]. Although it affects all age groups, children account for between 20% and 50% of all ocular injuries[2]. In those between 20 and 44 years of age, ocular injuries account for 10% of bilateral blindness[3]. Various reports have indicated that ocular trauma victims are predominantly young male patients, with lower socioeconomic status and relatively lower level of education[4]. Each year, there are 55 million eye injuries globally that restrict activities for more than one day. 19 millions have at least unilateral permanent reduction in vision and 1.6 million people are blinded by their injury[5]. Eye injuries are thus causing concern to Ophthalmologist both in the developed and developing countries[6].
The extent of injuries varies depending on the mechanism of the injury and the involvement of the ocular tissue. Understanding the fundamentals of eye trauma, evaluation and management will help to decrease the associated ocular morbidity and vision loss[7].
Besides the loss of vision, ocular injury generates a significant and often unnecessary toll in terms of medical care, human suffering, long term disability, productivity loss, rehabilitation service, and socioeconomic cost [5,8].
The principles of management of penetrating ocular injury are the same for children and adults. However, the management of the child is made more difficult by variable cooperation with both assessment and continuing therapy. It has been estimated that 90% of all ocular injury are preventable. Strategies for prevention require knowledge of the cause of injury and may hence enable more appropriate targeting of resources to ward prevention of such injuries
MATERIALS AND METHODS
All patients with open globe injury presenting to the Department of Ophthalmology, Liaquat University of Medical and Health Sciences over a three years period (January 2005 to December 2007) were included in the study. The age ranged from 660 years. A standardized form was used to extract the following data: age, sex, population type, occupation, laterality, source of injury, duration at presentation, mechanism of injury, initial visual acuity, location and extent of injury on the basis of ocular structures involved, causative object/agent of injury, tissues prolapsed, primary diagnosis, treatment, complications, other procedures (other than primary repair), functional and anatomical sequels and final visual outcome. Visual acuity was measured whenever possible according to the patients age and cooperation during the examination.
RESULTS
One hundred and twenty four eyes of 124 patients suffering from penetrating ocular injury were assessed. Over a three years period of study, one hundred and twenty four patients treated in the Department of Ophthalmology Liaquat University Eye Hospital, Hyderabad. The mean age was 35 years, (range 6 to 60 years). Males were 107(86.3%) and females 17 (13.7%, Table 1). Patients less than 20 years of age accounted for 74% of all injuries.
Eighty six percent of all injuries occurred in males. Of all the injuries, 73% cases belonged to rural population. Thirty eight percent patients belonged to different classes of labor including mechanic, farmer, driver, shop keeper etc, 20% patients were student and 42% patients were children.
Sixty one percent patients acquired injury during playing, 35% during their job while only 4% patients were injured by assault (Table 2) . Non projectile mechanism accounted for 72% of total injuries while 28% cases were of projectile nature (Table 2). Trauma with a wooden stick was found to be the most common cause in 35 patients (28.2%) followed by thorn injury in 21 cases (16%, Table 3). Eighty one percent of patients had the wound size of less than 5mm. 77% had only corneal cut, 18% had corneoscleral cut, 2% only scleral cut and 3% patients has total globe injury. 44% patients presented with iris prolapse.
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