玻璃体切除术治疗外伤性眼内炎

Vitrectomy for the treatment of traumatic endophthalmitis

目的探讨玻璃体切除治疗开放性眼外伤所致眼内炎的临床疗效。方法分析36例（36眼）外伤感染性眼内炎，进行玻璃体切除联合晶状体切除、视网膜脱离复位、眼内异物摘出，视网膜光凝、玻璃体腔注药及惰性气体或硅油填充等手术。部分患者应用了暂时性人工角膜技术。结果36例（100％）眼内炎术后均得到控制，眼球得以保存，视网膜复位良好。除4例幼儿视力检查不配合者外，1例术后仍无光感和1例术后仍为光感外，其余30例（93．75％，30／32）术后视力均有不同程度的提高。结论玻璃体切除联合手术治疗开放性眼外伤眼内炎疗效可靠。早期诊断和选择适当手术时机，能挽救大多数眼球，保留有用视功能。

Objective To evaluate the clinical effects of vitrectomy in treating endophthalmitis of open ocular trauma. Methods 36 cases （36 eyes） with traumatic endophthalmitis were treated with vitrec- tomy combined with lensectomy, reattachment of the detached retina, intraocular foreign body extraction, laser photocoagulation, drug infusion into vitreous cavity, and C3 Fs or silicone oil tamponade. The technique of temporary artificial cornea was used in some patients. Results Intraoeular infection of 36 cases（ 100% ） were controlled , the retinas were successfully reattached and the eye balls were saved, and the vision improved by varied degree in 30（93.75% ,30/32）eyes except 1 eye with light perception, and 1 eye with no light perception, and visual acuity examination could not be performed in 4 children. Conclusions Vitrectomy with combination therapie methods is effective for endophthalmitis due to open globe ocular trauma. Early diagnose and surgery oppotunity properly could save the eye balls and maintain the visual functions.