外伤性眼球脱臼合并视神经断裂1例并文献复习

Traumatic dislocation of the eyeball with optic nerve transection:a case report and literature review

目的报道1例外伤性眼球全脱臼合并视神经断裂患者的临床特点及诊疗过程,探讨眼球脱臼的治疗选择。方法1例因外伤导致右眼球全脱臼并视神经完全离断就诊的患者,在急诊下行右眼眼球全脱臼还纳+外眦切开+眼球探查+眼外肌缝合+眼睑裂伤清创缝合术还纳眼球,后又进一步行右眼羊膜遮盖+角膜清创+睑裂缝合术促角膜修复治疗。结果术后患者眼球复位,角膜愈合良好,术后6个月随访未出现并发症,患者对治疗结果满意。结论对于眼球脱臼的患者应及时处理,并根据具体情况制定手术方案,虽然全脱臼的患者已无视力恢复可能,但保留眼球在对患者心理负担的考量下可能是较好的选择。

Objective To report the clinical characteristics and diagnosis and treatment of a patient with traumatic total dislocation of the eyeball combined with optic nerve rupture and to explore the treatment options for dislocation of the eyeball.Methods A patient with total dislocation of the right eye and complete disconnection of the optic nerve due to trauma was treated in the emergency department.The patient's right eye was treated with repayment of total dislocation,lateral canthus incision,eye exploration,extraocular muscle suture,debridement,and eyelid laceration suture to restore the eyeball.The patient's right eye was then further treated with amniotic membrane covering,corneal debridement,and eyelid laceration to promote corneal repair.Results After surgery,the eyeball was repositioned,and the cornea healed well.There were no complications in the follow-up 6 months after surgery.The patient was satisfied with the treatment results.Conclusion Patients with dislocation of the eyeball should be treated in time,and the surgical plan should be formulated according to the specific situation.Although patients with complete dislocation do not have the possibility of vision recovery,retaining the eyeball may be a better option considering the psychological burden of the patients.