玻璃体切除术拯救外伤后无光感眼

Salvaging traumatized eyes with no light perception with vitrectomy

目的观察外伤后无光感眼采用玻璃体切除术治疗的效果。方法回顾性分析10例(10眼)行玻璃体切除术的眼外伤后无光感眼的临床资料。开放性眼外伤8例,闭合性眼外伤2例。术前并发症有视网膜脱离10眼、脉络膜脱离8眼、睫状体脱离4眼、玻璃体积血10眼、无晶状体5眼、无虹膜3眼及角膜血染1眼。所有病例均为硅油填充者。随访6个月以上。结果术后9眼视网膜解剖复位。5眼硅油填充眼压正常,2眼硅油填充眼压低,2眼取硅油后眼压正常,1眼眼球萎缩行眼球摘除术。术后视力5眼仍为无光感。2眼为手动,1眼为数指,1眼为0.05,1眼最佳矫正视力为0.2。结论玻璃体切除术可以拯救部分外伤后早期无光感眼,甚至可以恢复部分视功能。

Objective To evaluate the efficacy of vitrectomy for traumatized eyes with no light perception （NLP）. Methods Clinical data of 10 traumatized eyes with no light perception treated with vitrectomy from 2005 to 2007 were analyzed retrospectively. Male 9, female 1, average age 28.5 years old. Of them, eight had open globe injuries and two had closed blunt ocular trauma. Preoperative complications include retinal detachment 10 eyes, choroidal detachment 8 eyes, ciliary body detachment 4 eyes, vitreous hemorrhage 10eyes, aphakia 5 eyes, aniridia 3eyes, corneal blood staining 1 eye. Each case was tamponaded with silicone oil and followed up for longer than 6 months. Results Retinal reattachment was achieved in 9 eyes after surgery. The intraocular pressure（1OP） of 5 eyes tamponaded with silicone oil is normal, the lOP of 2 eyes tamponaded with silicone oil is lower than normal, the lOP of 2 eyes after silicone oil removal is normal. One eye was enueleated for phthisis bulbi. Postoperatively, 5 eyes remained NLP, 2 eyes have hand motion, 1 eye has counting fingers, the best corrected visual acuity of 2 eyes is 0.05 and 0.2. Conclusion Some early traumatized eyes with no light perception can be salvaged with timely vitreoretinal surgery. Some of them can even recover visual acuity to some extent.