Objective To summarize the visual outcome of patients with severe ocular trauma treated with vitreous surgery. Methods Clinical data of 188(191 eyes) with severe ocular trauma treated with vitreous surgery in a period from November 1996 to April 1998 were analysed retrospectively. Results The study included penetrating injury in 56 eyes, foreign bodies in the posterior segment in 70 eyes, blunt injury in 41 eyes , and globe rupture in 24 eyes. Main complications included endophthalmitis in 35 eyes, choroidal bleeding in 20 eyes, retinal detachment in 60 eyes, and vitreous hemorrhage in 97 eyes. Post-opera-tively, out of 188 eyes, except for 3 of patients too young to examine, visual acuity improved in 133(70.7%), including 85(45.2%) with visal acuity 0.02-1.0, 46(24.5%) remained unchanged; and 9(4.8%) had worse vision. Among 34 with no-light-perception, 12 had light-perception or over. Conclusion A majority of severe trauma eyes can be salvaged with considerable visual recovery after adequate and timely vitreous surgery. (Chin J Ocul Fundus Dis,1999,15:4-6)
Open ocular trauma in children is one of the main causes of non-congenital monocular blindness in children. Children’s psychological and daily activities are different from those of adults; the eye tissue structure is not maturely enough, and the characteristics of high response to injury and incompatibility with various diagnostic and treatment methods determine the factors that cause injuries and injuries in children with open ocular trauma. The environment, diagnosis and treatment, and prognosis of children are more complicated than adults. For the emergency of first and second stage on diagnosis and treatment of children with open ocular trauma, it should follow the principles of adult open ocular trauma management, combined with the children's characteristics, clarifying the anatomical location of the ocular trauma before surgery, and closing the wound during the first-stage operation. At the same time, the disturbance of intraocular tissue should be minimized, the timing of the second stage operation and the individualization of the operation design, and the medication and care after the operation should also be combined with the characteristics of children. Prevention of ocular trauma in children is the focus of attention. In the new information era, clinical research and public information platforms should be fully utilized to advance the epidemiological study of children's ocular trauma and guide the construction of the prevention and treatment system for children's ocular trauma more scientifically.
Open-globe injuries (OGI) result in complicated and diverse conditions with different mechanisms and anatomical locations, which lead to completely different outcomes based on when to perform pars plana vitrectomy (PPV) after trauma. The PPV operation time points are generally divided into early (0 - 3 days), delayed (4 - 14 days), and late (> 2 weeks). There are still some controversies about the PPV time points after OGI. Injuries with intraocular foreign bodies or high risk of infection usually need early surgery to reduce the occurrence of endophthalmitis. However corneal edema and vitreous hemorrhage can increase the difficulties for early diagnosis and surgery. If there is choroidal hemorrhage or severe trauma in the back part of the eye, delayed intervention can allow the blood clots to be liquefied and removed easily. But there is higher incidence of postoperative complications. Late surgery can reduce the difficulty of PPV, but the increased incidence of proliferative vitreoretinopathy may lead to severe retinal traction, tears and postoperative scar formation.
Objective To evaluate the clinical application value of ocular fundus photochromy and optical coherence tomography (OCT) in epimacular membrane of traumatic eyes following vitreorential surgery. Methods Ocular fundus photochromy and OCT were used to observe the morphological changes of macula in 139 consecutive patients with unilateral ocular trauma after vitreoretinal surgery between July 2003 and September 2004. Results At the 1st, 2nd, 3rd, 6th, and 12th month postoperatively, epimacular membranes were found in 5, 8, 17, 19, 20 patients, respectively by using photochromy; and in 7, 10, 20, 26, 27 patients, respectively by using OCT. There was no significant difference in epimacular membrane between photochromy and OCT(chi;2＝0.173，Pgt;0.05). The results of OCT showed that epimacular membranes completely adhered to the macular region in 8 patients（29.63%）, and retinal neurosensory layer swelled in 12 patients（44.44%）with the fovea thickness of (290.18plusmn;288.05) mu;m. Conclusion Ocular fundus photochromy and OCT are helpful in observing and discovering the epimacular membrane after virtreoretinal surgery of the patients with traumatic retinal detachment during the early and long-term follow-up period; and OCT can provide important information of the structue and position of these epimacular membranes hence to conduct to appropriate treatment. (Chin J Ocul Fundus Dis, 2006, 22: 236-238)
Purpose To observe the changes of choroidal circulati on and the retinal lesions caused by ocular contusion with indocyanine green ang iography (ICGA). Methods ICGA examination was performed on 30 cases (30 eyes) of various traumatic condition in conjunction with fundus fluorescein angiography (FFA). Results FFA of 19 cases (63.3%) showed the hypofluorence in quadrant or whole disc in accordance with the area of delayed filling of choroid. Twentysix cases (86.2%) showed d efected choroidel perfusion in ICGA,among them 16 cases showed localized delayed perfusion, in which the shortest perfusion time was 1 min 50 s and the l ongest time was 5 min.43 s,and 10 patients showed localized perfusion defect,and reversed filling time of retinochoroid vessels in 6 patients. Five cases (16.6%) had delayed filling time in both choroidal and central retinal vessels . Damage of retinal pigment epithelium was found in the areas of choroidal abnor mal perfusion. Conclusion ICGA combined with simultane ously FFA, is valuable in evaluating blunt injury of the ocular fundus and ben eficial to its diagnosis and treatment. (Chin J Ocul Fundus Dis, 2001,17:122-124)