帝京大学医学部附属病院における開放性眼外傷の検討

Review of open eye trauma treated at Teikyo University Hospital

要約　目的：帝京大学医学部附属病院で加療した開放性眼外傷の報告。

症例と方法：2009年4月からの8年間に当院で初期治療を行った62例62眼につき，最終視力に影響する因子を解析した。視力はlogMARとして評価した。

結果：男性28例，女性34例であり，62例の平均年齢は66.1±16.4歳であった。眼球破裂が52例，眼球穿孔が8例で，眼内異物と二重穿孔の症例はなかった。術前の平均視力は2.43±0.64，術後の平均視力は1.59±1.24で，有意に改善していた。因子解析では，網膜剝離，水晶体偏位・脱臼，硝子体出血，前房出血の有無，受傷機転と視力予後との相関があった。破裂部位と視力予後の間には相関がなかった。

結論：開放性眼外傷では，破裂の位置や大きさではなく，眼組織への損傷の程度が，最終視力に対する有意な因子であった。

Abstract　Purpose：To report the outcome of open eye trauma treated at the Teikyo University Hospital.

Cases and Method：We reviewed 62 cases of open eye trauma who received initial treatment at the Teikyo University Hospital during 8 years from April 2009. We evaluated various factors that might affect the final visual acuity. Visual acuity was evaluated after conversion to logMAR.

Results：The series comprised 28 males and 34 females. The age averaged 66.1±16.4 years. All were unilaterally affected. There were 52 cases of eyeball rupture and 8 cases of ocular perforation. There was no case of intraocular foreign body or double perforation. Visual acuity averaged 2.43±0.64 before treatment and 1.59±1.24 at the final evaluation. Factor analysis showed the following items as significantly correlated with the final visual acuity：presence of retinal detachment, deviation or dislocation of the lens, vitreous hemorrhage, anterior chamber hemorrhage, and causal features of injury. Final visual acuity was not correlated with the location of injury.

Conclusion：In open eye injury, final visual acuity was more correlated with the damage to the ocular tissue than the location or size of the wound.