Objective To evaluate the application of mechanical injury classifying system to predict the prognostic of closed-globe injuries.Methods Medical records of 337 patients (352 eyes) with closed-globe injury were retrospec-tively reviewed.Specific variables from a classifying system for mechanical injuries were analyzed:the mechanism of the in-jury, grade ( defined by initial visual acuity) , anatomic location, presence of relative afferent pupillary defect ( RAPD) . Additional variables, such as hyphema, traumatic iritis, traumatic cataract, vitreous hemorrhage, secondary glaucoma, op-tic nerve contusion, pre-hospital time, medical? insurance status, number of operations, duration of hospitalization, and hospitalization? expenses were also included in the analysis.Final visual outcome were recorded.Data were analyzed for predictors with univariate analysis and multivariate logistic regression analysis.Results After 6 months, 151 eyes (42.90%) achieved visual acuity 0.5 or better.According to univariate analysis Results, the following parameters were predictors of visual outcome:grade of the injury ( P <0.001), location ( P <0.001), presence of afferent pupillary re-sponse ( P <0.001), hyphema ( P =0.004), traumatic cataract ( P =0.001), secondary glaucoma ( P =0.004), optic nerve contusion ( P <0.001), duration of hospitalization ( P <0.001), number of operations ( P <0.001).How-ever, multivariate logistic regression analyses revealed that grade of injury ( P <0.001, OR=2.533, 95%CI=2.050~3.129), zone of injury ( P =0.013, OR=1.061, 95%CI=1.012~1.111) and number of operations ( P =0.029, OR=2.418, 95%CI=1.096~5.336) were the only significant factors for visual outcome.Conclusion Grade of the in-jury and location of the injury were significant prognostic factors for visual outcome in closed-globe injury.The classification system may become a useful prognostic tool for prediction of visual outcome in closed-globe injury.%目的：探讨机械性眼外伤分类系统对闭合性眼外伤（ CGI）预后评价的意义。方法连续入选2011年4月至2014年3月住院闭合性眼外伤337例（352只眼），对眼外伤的类型（根据损伤机制）、程度（根据损伤后最初视力）、区域（根据损伤的解剖位置）、相对性瞳孔传入障碍（ RAPD），及其他可能影响预后的因素如前房积血、外伤性白内障、继发性青光眼、视神经挫伤、就诊延迟时间（定义为眼外伤发生后至到医院接受诊治的时间间隔）、是否有医疗或伤害保险、手术次数、住院时间、住院费用等进行单因素及多因素逐步Log istic回归分析，以观察对预后视力的影响。结果病例随访至少6个月，预后好（视力≥0．5）151只眼，占42．90％，预后差（视力＜0．5）201只眼，占57．10％。单因素分析显示：损伤程度（ P ＝0．000）、损伤区域（ P ＝0．000）、RAPD（ P ＝0．000）、前房积血（ P ＝0．000）、外伤性白内障（ P ＝0．001）、继发性青光眼（ P ＝0．004）、视神经挫伤（ P ＝0．000）、住院时间（ P ＝0．000）、手术次数（ P ＝0．000）是影响视力预后的危险因素。而在多因素逐步Log istic回归分析之后显示：损伤程度（ P ＝0．000，OR ＝2．533，95％C I ＝2．050－3．129）、损伤区域（ P ＝0．013，OR ＝1.061，95％C I＝1．012～1．111）及手术次数（ P ＝0．029， OR ＝2．418，95％CI ＝1．096～5．336）是影响预后视力的独立危险因素。结论损伤程度、区域及手术次数是影响CGI视力预后的主要因素。机械性眼外伤分类系统有助于闭合性眼外伤的预后判断。
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