在没有眼内外体的开放球损伤中,视觉结果和内炎的风险与延迟修复
Marisa G Tieger1, Nakul Singh2, Racquel Bitar3
1Tufts University School of Medicine, Department of Ophthalmology, New England Eye Center, Boston, Massachusetts.
Ophthalmology
|July 3, 2024
概括
在24小时内修复开放球损伤 (OGIs) 是标准的,但这项研究发现,在24至36小时内进行修复时,内眼炎的发病率和视觉结果相似. 然而,眼内膜炎的风险在36小时后显著增加.
科学领域:
- 眼科医生 眼科 眼科
- 创伤外科 手术 创伤外科
背景情况:
- 开放球损伤 (OGIs) 是严重的眼睛紧急情况,需要及时管理.
- 优化OGI手术修复的最佳时间,以最大限度地减少诸如内眼炎之类的并发症,并最大限度地提高视觉效果,仍然是一个关键问题.
研究的目的:
- 为了比较24小时内进行手术修复的开放球损伤 (OGIs) 患者的内眼炎发生率和视觉结果,与24小时后修复的患者相比.
- 评估延迟修复 (25-36小时和>36小时) 对感染率和视力敏度的影响.
主要方法:
- 对1382名在单一机构治疗的开放球损伤 (OGIs) 患者进行了回顾性审查.
- 根据手术修复的时间来对患者进行分类:在24小时内,25-36小时内,超过36小时.
- 分析了180天和1年的内眼炎和术后视敏率 (logMAR).
主要成果:
- 大多数OGI (84%) 在24小时内得到修复;9%在25-36小时之间得到修复,7%在36小时后得到修复.
- 内膜炎与修复时间超过36小时 (P=0.049) 显著相关,但与25-36小时之间的修复无关.
- 手术时间没有显著影响最终的视力敏度结果,尽管女性性别是延迟修复 (>36小时) 的风险因素.
结论:
- 虽然一般建议紧急修复开放球损伤 (OGIs),但与24小时内修复相比,在25-36小时内修复并没有显示出内眼炎或更糟糕的视觉结果的统计显著增加.
- 经过36小时后的修复与内眼炎发病率增加有关.
- 在特定情况下,可以考虑延迟OGI修复超过24小时以优化手术条件而不会影响结果,只要不超过36小时.
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