Bir merkezin acil servisinde tedavi edilen gözün yabancý cisim travmalarý

AMAÇ
Yüzeysel korneal yabancý cisimler acil servise sýk baþvuran olgulardýr. Bu çalýþmanýn amacý, acil servise yabancý cisimlerle oluþan göz travmasýyla baþvuran olgularý tanýmlamak ve göz travmasýnýn önlenmesi ve acil servis yönetim stratejilerini tartýþmaktýr.
GEREÇ VE YÖNTEM
Çalýþma geçmiþ iki yýlýn kayýtlarý incelenerek geriye dönük olarak yapýldý. Demografik bilgiler, yaralanma zamaný, yaralanma tipi (açýk veya kapalý glob yaralanmasý), yabancý cismin ne olduðu, hastane yatýþ ve oftalmoloji konsültasyonu varlýðý, uygulanan tedaviler ve geç dönemde görülen kalýcý hasarlar kaydedildi.
BULGULAR
Toplam 476 hasta çalýþmaya alýndý, hastalarýn %83’ü erkekti, ortalama yaþ 34,16±14,02 idi. Yaralanmalarýn %9,7’si açýk glob yaralanmasý iken, kalanlar yüzeysel yabancý cisim bulunan veya bulunmayan kapalý yaralanmalardý. En sýk görülen yabancý cisimler metal çapaklarý (%37,6) ve toz (%31,1) olarak saptandý. Hastalarýn çoðunda (%72,1) iþ yerinde yaralanma söz konusuydu. Hastalarýn %42,4’ü oftalmoloji ile konsülte edilirken, diðer hastalar acil týp asistan ve uzmanlarý tarafýndan tedavi edildi. Hastalarýn %10’u hastaneye yatýrýldý ve %2,3’ünde uzun dönemde komplikasyon görüldü.
SONUÇ
Göz yabancý cisim travmalarý en çok genç saðlýklý erkeklerin, iþ nedenli yaralanmalarý olarak oluþmaktadýr. Çok sayýda göz travmasý acil servislerde görüldüðü için, acil servis hekimleri yüzeysel korneal yabancý cisimlerin tanýnmasý, tedavisi ve yönetimi konusunda eðitilmelidir.

Foreign body traumas of the eye managed in an emergency department of a single-institution

BACKGROUND
Superficial corneal foreign bodies (SCFB) are common injuries seen in the ED. The aim of this study was to describe the eye injuries caused by FBs and to determine clinical strategies for the prevention and management of ocular trauma.
METHODS
This was a retrospective chart review of the previous two years. Demographic data, timing of the injury, injury type (open- or closed-globe injuries), source of the FB, hospital admission and ophthalmology consultation, treatments, and the long-term complications were recorded for each patient.
RESULTS
There were 476 patients, and 83% were male, with an average age of 34.16±14.02 years. 9.7% of the eyes had an open-globe injury, while the rest were closed-globe injuries with or without SCFB. The most common FBs were metal fragments (37.6%) and dust (31.1%). The majority of the patients (72.1%) sustained work-related injuries. 42.4% of the patients were consulted to ophthalmology, and the remaining were treated by the emergency physicians. Only 10% of the patients required hospitalization, and complications were seen in 2.3% of the patients.
CONCLUSION
Ocular FB involved mainly young healthy males who had sustained work-related injuries. In view of the large number of eye injuries seen in EDs, ED colleagues should train themselves in order to appropriately recognize, treat and refer the SCFB injuries seen in the ED.