玻璃体手术联合后巩膜清创缝合术治疗眼球贯通伤的临床观察

Clinical observation of vitrectomy combined with suturing of posterior sclera for eyeball perforating wound

目的探讨玻璃体手术联合后巩膜清创缝合术治疗眼球贯通伤的疗效。方法对8例(8眼)眼球贯通伤患者行玻璃体手术联合后巩膜清创缝合术,6例先行一期前部角膜、巩膜伤口清创缝合,再行二期玻璃体手术;2例一期同时行前、后巩膜伤口清创缝合+玻璃体手术。随访4～12个月,观察患者视力、眼压、眼底等情况。结果 8例眼球贯通伤中术前视网膜脱离3例,术后视网膜均得到了解剖复位。术后视力均有提高,最高达0.6。术后眼压均在10～20mmHg(1kPa=7.5mmHg),平均14.4mmHg。术后无一例眼球萎缩、眼球摘除患者。结论玻璃体手术联合后巩膜清创缝合术治疗眼球贯通伤安全、有效。

Objective To investigate the clinical results of eyeball perforating wound treated by vitrectomy combined with suturing of posterior sclera.Methods About 8 cases（8 eyes） underwent vitrectomy combined with suturing of posterior scleral penetrating injury.Among the 8 cases,6 cases were taken suturing of anterior cornea and sclera and then taken vitrectomy;The other two cases were taken suturing of anterior and posterior sclera combined with vitrectomy.All cases were followed up for 4 to 12 months,and visual acuity,intraocular pressure and eyeground were observed.Results In 8 cases with eyeball perforating wound,3 cases were with preoperative retinal detachment,and all reached to its position postoperatively.Postoperative visual acuity improved in all cases and the highest reached to 0.6.Postoperative intraocular pressure was 10 to 20 mmHg（1 kPa=7.5 mmHg）,averaging in 14.4 mmHg.There was no case with atrophy or enucleation of eyeball postoperatively.Conclusion Vitrectomy combined with suturing of posterior sclera is an effectively surgical method in the treatment of eyeball perforating wound.