重症眼外伤玻璃体切割治疗时机的研究

Study on operative timing of vitrectomy for severe ocular trauma

目的探讨早期玻璃体切割术治疗重症眼外伤的手术时机和治疗效果。方法收集行玻璃体切割术治疗的重症眼外伤患者60例(60眼),按照外伤后玻璃体切割手术时间分为1-4d组(28眼)、5-14d组(24眼)和14d以上组(8眼),观察术后视力恢复和视网膜脱离发生情况,对玻璃体切割手术时机和治疗效果进行综合分析及评价。结果60眼患者术后视力达到功能治愈40眼;1-4d组功能治愈20眼,解剖治愈8眼;5-14d组功能治愈18眼,解剖治愈5眼,1眼未愈;14d以上组功能治愈2眼,解剖治愈3眼,未愈3眼。玻璃体切割术后出现视网膜脱离5眼,其中5-14d组1眼,14d以上组4眼。结论重症眼外伤早期行玻璃体切割术治疗效果好,最佳手术时机为眼外伤后1-4d。

Objective To investigate the operative timing and treatment outcomes of vitrectomy for severe ocular trauma.Methods Sixty cases（60 eyes）with severe ocular trauma were collected to take vitrectomy,and divided into three groups according to the time of taking vitrectomy after ocular trauma,1 day to 4 days group（28 eyes）,5 days to 14 days group（24 eyes）and more than 14 days group（8 eyes）.The recovery of postoperative visual acuity and retinal detachment were observed.Operative timing and treatment outcomes of vitrectomy were analyzed and evaluated. Results Postoperative visual acuity of 40 eyes was functionally cured in 50 eyes. In 1 day to 4 days group, postoperative visual acuity was functionally cured in 20 eyes, was anatomi- cally cured in 8 eyes. In 5 days to 14 days group, 18 eyes were functionally cured,5 eyes were anatomically cured and 1 eye was not cured. In more than 14 days group,2 eyes functionally were cured, 3 eyes were anatomically cured and 3 eyes were not cured. There were 5 eyes with retinal detachment after vitrectomy, of which was 1 eye in 5 days to 14 days group and 4 eyes in more than 14 days group. Conclusion Vitrectomy has a good treatment outcome for severe ocular trauma, the proper operative timing is about 1 day to 4 days after ocular trauma.