方法：选取2014-03/2015-06我院收取的90例90眼行玻璃体切除术的眼后段外伤患者作为研究对象进行回顾性分析。记录患者的年龄、性别、视力、创伤发生地点、解剖学位置、损伤属性、伤口长度、传入性瞳孔障碍的发生、手术时间等信息。使用眼外伤评分(OTS)对患者的视力进行评价。所有患者均随访6mo以上。

结果：所有入选患者均获得182～240(中位数198)d随访。所有患者中男77例77眼，女13例13眼，平均年龄32.7±15.8岁。47例47眼(52%)患者的创伤发生在工作场所，14例14眼(16%)发生在家庭。患者平均视力(LogMAR)从术前(2.36±0.72)到术后(1.50±1.14)得到明显改善。术前患者23例23眼的视力好于2.0，这些患者的术后视力改善显著优于术前视力较2.0差的患者，差异有统计学意义(P<0.01)。早期手术组(<7d)与延迟手术组(>7d)相比视力改善值无显著统计学差异(P>0.05)。损伤发生在Ⅰ区和Ⅱ区的患者术后视力无显著统计学差异(P>0.05)，但Ⅲ区损伤患者的术后视力显著差于Ⅰ区和Ⅱ区患者，差异有统计学意义(P<0.05)。发生传入性瞳孔障碍的患者术后视力更差，差异有统计学意义(P<0.05)。不同OTS评分患者相比，术前、术后视力及术前术后视力差均具有显著统计学差异(P<0.01)。

结论：眼后段损伤更易发生于40岁以下的男性，且发生地点多为工作地。患者的术后视力与传入性瞳孔障碍、OTS评分、视力损伤区域相关，与手术时机无关。

METHODS:A total of 90 patients(90 eyes)with ocular injuries involving the posterior segment underwent pars plana vitrectomy in our hospital from March 2014 to June 2015 were recruited to carry out a retrospective study. We recorded the age, gender, occurrence site of trauma, visual acuity, anatomical site, nature of injury, wound length, the presence of an afferent pupillary defect, and the timing of vitrectomy. The Ocular Trauma Score was measured. The minimum follow-up from presentation was 6mo.

RESULTS:The mean duration of follow up was 198d, ranged from 182 to 240d. There were 77 males and 13 females of all, with a mean age of 32.7±15.8 years old and 47 patients(52.2%)injured in the workplace, 14 patients(15.6%)at home. The mean visual acuity(LogMAR)of patients were significantly improved from 2.36±0.72 preoperatively to 1.50±1.14 postoperatively. There were 23 patients whose preoperative vision were better than 2.0 LogMAR, the postoperative visual acuity of these patients were significantly better than others(P<0.01). No significant difference of visual improvement was found between groups with early vitrectomy(<7d)or delayed vitrectomy(>7d)(P>0.05). There was no significant difference of postoperative visual acuity between patients with injury in Zone I and II(P>0.05), but visual acuity of patients with injury in Zone III were significant poorer(P<0.05). The postoperative visual acuity of patients with relative afferent pupillary defect were significant poorer(P<0.05). Preoperative visual acuity, the difference of preoperative and postoperative visual acuity, and postoperative visual acuity were significantly different between groups with different ocular trauma scores(P<0.01).

CONCLUSION:Trauma is more likely to occur in men under 40 years of age and in the workplace. The favorable final visual outcome is associated with the absence of afferent pupillary defect, ocular trauma score and presenting visual acuity as well as the zone of injury, and not associated with the timing of vitrectomy.