探讨玻璃体切除术对严重眼外伤的治疗效果

Clinical efficacy of vitrectomy for severe ocular trauma

目的 探讨玻璃体切除术治疗严重眼外伤的效果。方法 严重眼外伤48例（48眼），其中穿孔伤28例，眼球挫伤12例，眼内异物8例，均采用经睫状体平坦部的闭合式三通道玻璃体切除术。分别于术前、术后1周及3月随访时测定眼压及视力，并进行对比。结果 术后3月眼压6．0—9．5mmHg、10．0—21．0mmHg及21．5—34．0mmHg（1mmHg=0．133kPa）段与手术前相比，差异具有统计学意义。眼压过低过高者减少，眼压正常者增加。术后1周及术后3月视力为无光感及光感者分别占37．50％和31．25％，均显著低于手术前的81．25％。视力为手动-0．2者占62．50％和68．75％，均显著高于手术前的18．75％，差异具有统计学意义。结论 玻璃体切除术治疗严重眼外伤效果良好，能有效缓解眼压，提高视力。

Objective To evaluate the effect of vitrectmny for severe ocular trauma. Methods Pars plana vitrectomy was performed in 48 eyes of 48 cases with severe ocular trauma, including 28 cases with perforation, 12 cases with eyeball contusion, and 8 cases with intraoeular foreign body. The intraoeular pressure （IOP） and vision were measured preoperatively, 1 week and 3 months postoperatively. The results were compared. Results Comparing with the preoperative one, the lOP of 6.0 ~ 9.5 mmHg, 10.0 - 21.0 mmHg, and 21.5 - 34.0 mmHg group manifested significant difference 3 months after surgery. The number of patients with too high or low IOP reduced, and the number with normal intraocular pressure increased. In postoperative 1 week and 3 months, the percentage of patient with no light perception was 37.50% and light perception 31.25%, and it were significantly lower than the preoperative one （81.25% ）. The visual acuity which was hand movement to 0.2 accounted for 62.50% and 68.75% respectively, which were significantly higher than the preoperative one （ 18.75% ）. The difference was statistically significant. Conclusion Vitrectomy has a good effect on severe ocular trauma, and can effectively reduce the IOP and improve visual acuity.