晶状体玻璃体切割术治疗严重眼球爆炸伤21例临床观察

Crystalline-vitrectomy for severe explosive eyeball injuries:review of 21 cases

目的评价晶状体玻璃体切割术对严重眼球爆炸伤的治疗价值和效果。方法复习连续的21例（21眼）严重眼球爆炸伤患者采用晶状体玻璃体切割术等技术治疗的临床资料。手术技术有：巩膜外环扎和垫压、晶状体和玻璃体切割、眼内电凝和冷凝、视网膜前膜剥膜、眼内异物取出、气／液交换、过氟化碳液体应用、硅油或过氟丙烷（C3F8）充填、二期人工晶状体缝合植入等。结果出院时，治愈率为76．2％。其中17例随访3～28个月，平均11．8个月。末次随访时，痊愈12眼（70．6％，12／17），视力〉0．02者9眼（52．9％，9／17），其中视力≥0．1者6眼（35．3％．6／17），最佳矫正视力达0．6。结论晶状体玻璃体切割术等技术是目前治疗严重眼球爆炸伤病变最有效的方法。

Objective To evaluate the therapeutic effects of crystalline - vitrectomy in severe explosive injuries of the eyeball. Methods Clinical records were reviewed on 21 consecutive patients （21 eyes） with severe explosive eyeball injuries treated by varied procedures of eye surgery. Results The cure rate on discharge was 76.2% （16/21）. 17 eyes were followed - up for 3- 28 months （average 11.8 months） to find long- term therapeutic effectiveness in 12 of them （70.6%）. The final vision was 〈 0.02 in 3 cases, and 〉 0.02 in 9 cases, of which 6 had a vision of 0.1 to 0.6. The other 5 cases resulted in atrophy of the eyeball. Conclusion Crystalline - vitreoretinal surgery is so far the best effective method for severe explosive eyeball injuries.