Clinical features and surgical prognosis of 175 patients with ocular penetrating injury involving posterior segment
ZENG Renpan1, WANG Danling1, QIAN Ping1, ZHANG Wei1, CHEN Bin2, LI Han2, WANG Guoping3
1. Department of Ophthalmology, Sichuan Provincial Corps Hospital of Chinese People's Armed Police Force, Leshan 614000, China; 2. Department of Fundus Disease,Leshan Ophthalmic Center, Leshan 614000, China; 3. Department of Fundus Disease,Ophthalmic Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu 610000, China
Abstract：Objective To study the clinical features and surgical prognosis of patients with ocular penetrating injury involving posterior segment. Methods A multicenter retrospective study was conducted. A total of 175 patients (175 eyes) with ocular penetrating injury involving posterior segment who underwent pars plana vitrectomy (PPV) in three hospitals of Sichuan province from January 2013 to December 2022 were collected, and the clinical features, the time from injury to hospitalization, and the time from injury to PPV were recorded. The patients were followed up 1 to 6 months after PPV, Visual acuity, intraocular pressure, refractive media, retinal reattachment, enucleation of eyeballs and complications were recorded at each follow-up. According to the final follow-up results, the surgical prognosis was evaluated as anatomical recovery, functional recovery, and non-recovery. Results All patients were monocular affected, the ratio of male to female was 12.5:1, and the average age was 46.6±13.8 years old. Metal objects with high speed were the most common cause of injury (51.4%), and 56.0% of the affected eyes had intraocular foreign bodies, of which metallic foreign bodies accounted for 84.7%. Zone 1 was the most common injury area (68.6%), and preoperative visual acuity were mainly distributed in LP-0.02 (76.0%), usually accompanied by lens injury (77.1%), anterior chamber vitreous hemorrhage (53.7%) and retinal detachment (38.9%). Most patients were admitted within 24 hours (58.9%), PPV were mainly performed within two weeks after injury (84.6%), and silicone oil filling accounted for 33.1%. A total of 49.1% of the affected eyes were anatomically cured, 45.7% were functionally cured, and the total cure rate was 94.9%, 5.1% were not cured, and 1.1% were enucleated. The overall incidence of postoperative complications was 17.1%. Conclusions The main clinical features of patients with ocular penetrating injury involving the posterior segment are middle-aged males with single eye involvement, mostly caused by high-speed metal objects and in Zone 1, usually accompanied by intraocular metal foreign bodies, intraocular bleeding, lens damage and retinal detachment, with serious visual impairment. PPV is mainly performed within two weeks after injury, with good surgical effect and prognosis.
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2024, Vol. 35 
