急诊手术治疗角巩膜穿通伤的临床体会

Clinical experience with emergency surgical in treatment of corneal and scleral penetrating injury

目的：观察急诊手术治疗角巩膜穿通伤的应用效果。方法角巩膜穿通伤患者56例（56只眼），清创缝合术时，联合色素膜复位术29只眼，虹膜根部离断缝合修补术3只眼，前房形成术19只眼，前房冲洗术8只眼，白内障囊外摘除术20只眼，白内障囊内摘除＋前段玻璃体切割术4只眼，玻璃体磁性异物取出术3只眼，白内障囊外摘除＋晶状体异物取出术4只眼。结果56例（56只眼）患者中5只眼视力无恢复，其中包括术前视力无光感2只眼，光感3只眼；51只眼均恢复了部分视力。术后视力院无光感者2只眼，光感~0.02者18只眼，0.02~0.1者23只眼，0.1~0.3者9眼，0.3以上者4只眼。结论急诊手术时娴熟技术水平和恰当手术方案可提高患者伤眼视功能恢复的可能性。

Objective To observe the effect of emergency surgical in the treatment of corneal and scleral penetrating injury. Methods 56 cases of patients with corneal with scleral injury （56 eyes） underwent debridement and suturing,29 eyes among the total were combined with reposition of iris,3 eyes were with iridodialysis reposition,19 eyes were with the anterior chamber re-formed operation,8 eyes were combined with anterior chamber washout,20 eyes were with the extracapsular cataract extraction,4 eyes were with the intracapsular cataract extraction with the anterior vitrectomy,3 eyes were combined with the extraction of foreign body,4 eyes were with the intracapsular cataract extraction with crys-tal foreign body removal. Results In the 56 patients （56 eyes）,there were 5 eyes had visual impairment,including preop-erative vision were no light perception in 2 eyes,light perceptiont in 3 eyes,the visual acuity was improved in 51 eyes. Postoperative vision： no light perception in 2 eyes,18 eyes were ≤0.02,23 eyes were 0.02-0.1,9 eyes were 0.1-0.3,4 eyes were ≥0.3. Conclusion When in emergency operation,skilled operational ability and proper operation scheme can increase the possibility of injury eyes recovery.