十年来角膜穿孔伤病例分析及治疗方法的探讨

Analysis and discussion of treatment on corneal penetrating injury, A 10-year review

目的分析10年来角膜穿孔伤病例并研究黏弹剂作为软手术器械在角膜穿孔伤及其并发症术中的作用。方法对112例（112眼）角膜穿孔伤进行分析，并对术中应用黏弹剂作为软手术器械进行处理的效果进行总结。结果术后视力t〉0．6者占33．04％；0．3—0．5者占50．89％。术后散光（-1．50±1．00）D。18眼术后出现高眼压，其中应用透明质酸钠（爱维）的67眼中20．90％（14眼）术后出现高眼压。经降眼压等对症处理后，5d内恢复正常。而用羟丙基甲基纤维素（优维素）45眼中仅有8．89％（4眼）发生术后一过性眼压增高。未作任何处理，3d内自行恢复正常。有轻度虹膜炎者29眼，经滴眼治疗，均于1周内恢复正常。无眼内炎等严重并发症发生。结论在角膜穿孔伤及并发症手术中应用黏弹剂作软手术器械，术后视力明显提高，降低了角膜散光，无严重并发症。

Objective To study the applying of viscoelastics in the surgery for corneal penetrating injury and its complications. Method Applying of viscoelastics in 112 cases （112 eyes） with corneal penetrating injury repairing and analyzing of complications. Results The postoperative vision better than 0.6 accounted for 33.04% ; between 0.3 and 0.5 accounted for 50. 89%. The postoperative astigmatism was （ 1.50± 1.00） D. Ocular hypertension occurred in 18 eyes. 14 eyes （20.90% of 67 hyaluronicacid eyes） returned to normal in 5 days after symptomatic treatment. 4 eyes （8.89% of 45 hydroxypropyl methyl cellulose eyes） returned to normal in 3 days without treatment. 29 eyes with mild iritis returned to normal within one week. No serious complicaton such as endophthalmitis occurred. Conclusion Applying of viscoelastics in the corneal penetrating injury and complications could improve the vision and reduce corneal astigmatism. It＇ s a worthy application methods with high safty, low side effects and complications.