儿童眼外伤玻璃体切除术临床分析

Vitrectomy for childhood ocular trauma

目的探讨玻璃体切除术治疗儿童眼外伤的疗效。方法应用玻璃体切除术治疗12岁以下儿童眼外伤100例(100眼),受伤眼均有2种以上不同程度的病变,如玻璃体积血、视网膜脱离、眼内炎及眼内异物等。结果100例中男86例,女14例。各种植物性物体损伤24例,各种金属物体损伤22例,爆炸伤21例,玻璃伤7例,塑料子弹伤4例,车祸伤4例,注射器伤3例,其他15例。其中合并角膜裂伤33例,白内障48例,视网膜脱离48例,眼球萎缩4例,眼内异物(已摘出)21例。手术中联合硅油充填65例,晶状体切除71例,眼内注气17例。100例中9例因视网膜脱离再次行玻璃体切除硅油充填术,其中3例眼球萎缩。结论玻璃体切除术对治疗儿童眼外伤具有良好的治疗效果,增生性玻璃体视网膜病变导致牵拉性视网膜脱离是手术失败的主要原因。

Objective To report the indications, complica-tions and outcomes of vitrectomy for childhood ocular trauma. Methods Retrospectively studied 100 children （age 12 years or less） undergoing vitrectomy following ocular trauma, they had two or more different symptoms of examples vitreous hemorrhage, retinal detachments, endophthalmitis, intraocular foreign body,et al. Re- sults Eighty-six boys and fourteen girls were reviewed, incluing different injury induced by plant （24cases） , metal （22cases） , ex-plosive injury （21cases） , blunt injury （4cases） , glass injury （7cases） ,plastic bullet injury （4cases） , road accident （4cases） , syringe injury （3cases） and other reasons （15cases）. Thirty-three cases have wound in cornea, forty-eight had traumatic cataract, for- ty-eight had retinal detachments. Four case had atrophy of eyeball, twenty-one had intraocular foreign body ; Sixty-five were performed with silicone tamponade, seventy-one with lensectomy, seventy-one was injected SF6 or other gases. Retinal re-attachment was a- chieved after one procedure in 9 with second vitrectomy, three ca- ses have atrophy of eyeball. Conclusions Vitrectomy is an impor- tant therapeutic option for eye injuries in children. Proliferative vit- reoretinopathy was the cause of redetachment and the cause of fail- ure of treatment.