外伤性视网膜脱离的诊断和治疗

The Diagnoses and Treatment of Thiumatic Retinal Detachment

目的:本文回顾性探讨了外伤性视网膜脱离的诊断和治疗。方法:连续25例外伤性视网膜脱离病例,眼挫伤12眼,爆炸伤4眼,穿通伤9眼;PVR≤C级16眼,D级9眼。第一种术式:巩膜冷凝,硅胶填压,环扎,放水术,主要用于PVR≤C级病例;第二种术式,玻璃体切除、硅油填充,主要用于穿通伤的PVR-D级患者。结果:第一种术式治愈率91.67％,第二种术式治愈率69.23％;视力提高率:部分视网膜脱离高于全视网膜脱离(P<0.01)、PVR≤C级高于PVR-D级(P<0.05)、非穿通伤高于穿通伤(P<0.05)。结论:有眼挫伤病史和症状者,应扩瞳仔细检查眼底,早期发现和治疗视网膜脱离;对严重穿通伤视网膜脱离,应行第一种术式联合玻璃体切除,眼内填充术。眼科学报1996;12:193～195。

Purpose:The diagnoses and treatments of traumatic retinal detachment (RD) were studied retrospectively in this article. Methods: Asequence of 25 eyes of traumatic RD included 12 eyes of contusion, 4 explosion and 9 perforation; PVR(Proliferative vitreoretinopathy)≤C grade 16 eyes and D grade 9 eyes. The techniques were one; scleral cryotherapy, silicon band buckling and circling, external drainage, which was mainly used to PVR≤C cases; two; vitrectomy and silicon oil tamponade, which was mainly used to the cases of perforated PVR - D cases. Results: retinal reattachment rate was 91. 67% in technique one and 69. 23% in technique two. Improvement of visual acuity showed that partial RD was better than total RD(P<0. 01) ,PVR≤C better than PVR-D(P<0.05) and non- preforated better than perforated (P<0.05). Conclusion :The patient who had a history and visual symptoms after an eye injury must be carefully examinated by dilating pupil in order that the RD could be early inquired and treated. The techniques one and two must be preformed in the severe perforated cases. Eye Science 1996;12:193 - 195.