玻璃体视网膜手术治疗严重角巩膜裂伤的临床疗效

Clinical research on the effect of vitreoretinal surgery for severe corneoscleral laceration

目的:探讨、评价并分析玻璃体视网膜手术治疗严重角巩膜裂伤的临床疗效。方法:对我院2009-03/2010-03住院的37例37眼角巩膜裂伤患者行玻璃体切割术治疗,根据术中视网膜情况辅以硅油充填、视网膜激光光凝。结果:手术后随访3～6(平均5)mo,随访中行视力、最佳矫正视力、眼压及眼底检查,部分患眼进行了眼B超、OCT和眼底照相检查。患者中31例31眼玻璃体腔清晰,视网膜复位良好,其中≥0.1者由术前2眼增加到术后的11眼,术后视力不同程度提高28例28眼,术后视力无变化3例3眼;6例6眼术前术后视力无光感,因术后眼球萎缩行眼球摘除联合义眼台植入。结论:玻璃体切割术是治疗严重角巩膜裂伤的有效方法。早期手术治疗,可使大多数患者术后患眼视功能改善,并发症少,手术安全有效。

AIM：To investigate, evaluate and analyze the clinical efficacy of vitreoretinal surgery in the treatment of severe corneoscleral laceration. METHODS：From 2009- 03 to 2010- 03 in our hospital, 37 cases （37 eyes） of hospitalized patients with corneoscleral laceration underwent vitrectomy, according to intraoperative conditions combined with silicone oil filling and retinal laser photocoagulation. RESULTS：Post-operative follow-up was 3 to 6（average 5）months with visual acuity, best corrected visual acuity, intraocular pressure and fundus examination, and eye B-ultrasound, OCT and fundus photographic examination for partial affected eyes. Clear vitreous cavity and good retinal reattachment were in 31 cases （31 eyes）, among which the number of visual acuity ≥ 0.1 was increased from preoperative 2 eyes to postoperative 11 eyes, visual acuity was improved in 28 cases （28 eyes） at different dagrees, visual acuity remained unchanged in 3 cases （3 eyes） postoperation; 6 cases（6 eyes）without light perception before and after operation underwent eyeball enucleation joint orbital implantation due to postoperative eyeball atrophy. CONCLUSION：Vitrectomy is an effective way for severe corneoscleral laceration. Early surgical treatment may improve postoperative visual function of the affected eyes for most patients with fewer complications.The surgery is safe and effective.