玻璃体切除硅油填充治疗无网脱外伤性眼内炎

The treatment of traumatic endophthalmitis with vitrectomycombined with silicone oil injection in eyes without retinal detachment

目的探讨玻璃体切除联合硅油填充手术治疗无视网膜脱离的外伤性眼内炎的疗效,并分析相关因素.方法 18例(18眼)因外伤性眼内炎接受玻璃体切除联合硅油填充手术,其中10眼于术后6月将硅油取出,并且6眼同时植入人工晶状体.术前视力光感至0.1.眼压平均为9 mmHg(5～23mmHg),(1 mmHg=0.133kPa).平均随访18月(3～43月).结果术后视力手动至0.8,视力提高15眼(83.33%),不变3眼(16.67%).眼压平均为17 mmHg(10～20mmHg),显著高于术前眼压(P<0.05).无视网膜脱离或眼球萎缩.并发症主要包括前房炎性渗出(16眼),术后短暂高眼压(3眼).结论玻璃体切除联合硅油填充手术是治疗无视网膜脱离的外伤性眼内炎安全有效的方法.

Objective To explore the effects of vitrectomy combined with silicone oil injection in the treatment of traumatic endophthalmitis in eyes without retinal detachment, and analyze the relative factors. Methods Eighteen eyes （18 patients） of traumatic endophthalmitis without retinal detachment received the treatment of vitrectomy combined with silicone oil injection. Silicone oil was removed 6 months postoperatively in 10 eyes, and intraocular lens implantations were performed in 6 of 10 eyes in the meantime. Preoperative visual acuity ranged from light perception to 0.1. The mean preoperative intraocular pressure was 9 mmHg with a range from 5 to 23 mmHg. Follow-up ranged from 3 to 43 months with a mean of 18 months. Results The postoperative visual acuity ranged from hand moving to 0.8. The vision increased in 15 eyes （83. 33%）, and was stable in 3 eyes （16.67%）. The mean postoperative intraocular pressure was 17 mmHg with a range from 10 to 20 mmHg, and was significantly higher than preoperative one （P 〈 0.05）. There was no retinal detachment and ocular atrophy. Postoperative complications mainly included fibrosis exudates in the anterior chamber （16 eyes） and temporary intraocular pressure elevation （3 eyes）. Conclusion Vitrectomy combined with silicone oil injection is a safe and effective method in treating traumatic endophthalmitis in eyes without retinal detachment. vitrectomy;