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)
The pathogensis of choroidal vascular changes in traumatic rtinopethy remains uncertain.We performed scanning electron micrmcopie (SEM) observation of methyl methalerylare vascular corrosion casts in a rabbi model with severe retinal contusion. Areas of filling defects in corrosion casts of the choriocapillaries, correspending to the areas of impact retinal lesions were noted in the traumatized eyes one to 28 days after trauma.No neovascularization was found in the eyes 56 days after trauma. The results confirm that obstruction and disappearance of involved choriocapillaries are the main changes of choroidal vasculatrue in severe blunt tram. The changes may be associated with continuous necrosis, of the photoreceptors 4 weeks after injury. （Chin J Ocul Fundus Dis,1993,9:5-7）
Objective To find out about the characteristics and prognosis of retinal detachment due to ocular contusion.Methods The clinical data of 36 patients(36 eyes)with retinal detachment due to ocular contusion were retrospectively analyzed.Results There were 3 eyes(8．3％)with huge retinal hole(≥90°)，4 eyes(11．1％)oral tear of ora serrata retinae，4 eyes(11．1％)with macular hole，3 eyes(8.3％)with tractive retinal detachment，and 22 eyes(61．2％)with retinal hole(lt;90°)at other positions(including temporal peripheral hole in 9，nasal peripheral hole in 5，and posterior polar hole in 8).Proliferative vitreoretinopathy(PVR)was found in a11 patients withConclusions Retinal detachment due to ocular contusion often go with PVR．The interval from contusion to retinal detachment varies from days to months.Visual prognosis can be good when retinal detachment is diagnosed and treated in time． (Chin J Ocul Fundus Dis，2004，20：1-66)
Objective To study the factors affecting the prognosis of vitrectomy in mechanically injured eyes. Methods One hundred and thirty-Seven eyes undergone vitrectomy were in cluded.Recorded to EPIINFO data base were visual acuity (VA) immediately after injury,type and location of injury,the interval from injury to surgical intervention,retinal detachment,basic surgical maneuvers,proliferative vitreo-retinopathy (PVR),stage of trauma,complications,final VA,and final retinal status.Data were analyzed by SAS. Results We got anatomic success in 107 eyes (75.9%).Final VA of 74 eyes (54.1%) were better than 0.02.Multiple-variable analysis showed that the factors significantly affecting prognosis of vitrectomied eyes of mechanical injury were retinal detachment (RD) before surgery,delay of surgical intervention,complexity of surgical maneuvers,complications after surgery. Conclusions RD before surgery,delayed surgical intervention,complexity of surgery and post vitrectomy complications are the most important factors contributing to the poor prognosis of VA and failure of surgery. (Chin J Ocul Fundus Dis，2000，16：139-212)
Objective To observe the changes of electroretino gram(ERG) in temporary traumatic ocular hypotension and to detect the possiblem echanism. Method The rabbit model with ocular hypotenstion was made. At the 2nd, 4th, 8th, 16th week after trauma, the ocular tension and ERG was examined. Result Amplitude of b wave in treated group was 2.5 times as high as that in the control at the 2nd week after trauma, and then decrease to 1.5 times as high as that in the control at the 16th week. Conclution Higher amplitude of b-wave of ERG in rabbit with ocular hypotension may be related to blood circulation congestion, which might lead to accumulation of the metabolic toxin. (Chin J Ocul Fundus Dis，2004，20：189-191)
Objective To evaluate the influence factor of the prognosis of traumatic subretinal hemorrhage after vitreoretinal surgery. Methods The clinical data of 50 patients with traumatic subretinal hemorrhage who had undergone vitreoretinal surgery were retrospectively analyzed.All patients had ocular traumatic history and subretinal hemorrhage diagnosed by fundus and B-scan examination;the preoperative visual acuity was less than 0.1. According to different conditions, the traumatic eyes were treated with vitreo-retinal surgery, combined with lensectomy, retinotomy or silicone oil tamponade, respectively. The period of follow-up after surgery was 2-53 months, and the average period was 7.27 months. The corrected visual acuity and retinal reattachment at the last follow-up were observed. The visual acuity ge;0.1 was the standard of good prognosis; retinal reattachment was observed by indirect ophthalmoscope and color fundus photography.The prognostic factors mainly included type of injury,open or closed injury,the disease course, preoperative visual acuity, retinal detachment,hemorrhagic choroidal detachment,vitreous hemorrhage,the sites of submacular hemorrhage,methods of surgery.The relationships between those prognostic factors and visual acuity outcome or retinal reattachment were analyzed by chi;2test and logistic regression analysis. Results About 46.0% patients had good prognosis of the visualacuity. In the eyes with preoperative visual acuity of no light perception to hand moving and finger counting to 0.1, the rate of good visual acuitywas 34.2% and 83.3%, respectively; the difference between the two groups was significant (chi;2=8.860,P=0.003). In the eyes with or without preoperative retinal detachment,the rate of good visual acuity was 37.5% and 80.0%, respectively; the difference between the two groups was significant (chi;2=4.232,P=0.040). In the eyes with subretinal hemorrhage involving the macular fovea or not, the rate of good visual acuity was 34.4% and 66.7%,respectively; the difference between the two groups was significant (chi;2=4.836,P=0.028).All the other prognostic factors had no obvious effect on the retinal reattachment after the surgery. Conclusion Preoperative visual acuity、retinal detachment and submacular retinal hemorrhage were the important influence factors associated with prognostic visual acuity of eyes with traumatic subretinal hemorrhage after vitreoretinal surgery.
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.