严重眼外伤非接触广角观察系统下玻璃体视网膜手术

Non-contact wide-angle viewing system assisted vitreoretinal surgery for severe ocular trauma

目的 探讨非接触广角观察系统下玻璃体视网膜手术治疗严重眼外伤的临床效果.方法 回顾性分析2013年6月至2014年9月接受非接触广角观察系统下玻璃体视网膜手术的严重眼外伤36例（36只眼）的临床资料,对手术效果进行临床分析.结果 严重眼外伤病情错综复杂,常多组织多结构外伤同时存在：其中眼内异物15只眼,摘出率100％;玻璃体积血26只眼,脉络膜上腔积血5只眼,术中清除积血,术后无再次出血者;视网膜脱离20只眼,复位率85.00％;化脓性眼内炎8只眼,炎症均控制.36只眼中术后视力提高者26只眼（72.22％）,视力无改变者6只眼（16.67％）,视力减退者4只眼（11.11％）.结论 非接触广角观察系统能够为严重眼外伤的玻璃体视网膜手术提供宽广的手术视野,降低屈光间质浑浊对手术的影响,简化手术操作.

Objective To investigate the clinical efficacy of vitreoretinal surgery under non-contact wide-angle viewing system for severe ocular trauma.Methods The data of 36 eyes of 36 patients with severe ocular trauma treated by vitreoretinal surgery under non-contact wide-angle viewing system from June 2013 to September 2014 were retrospectively analyzed.Results The eye condition of these patients was complex and the injury in multiple tissues coexisted.The successful rate of the extraction of intraocular foreign bodies from 15 eyes was 100%.After the surgery,there were 26 eyes with vitreous hemorrhage and 5 eyes with suprachoroidal hemorrhage.The rate of reattachment in 20 eyes with retinal detachment was 85.00%.Suppurative endophthalmitis in 8 eyes was well controlled.The postoperative visual acuity improved in 26 eyes （72.22%）,unchanged in 6 eyes （16.67%） and decreased in 4 eyes （11.11%）.Conclusion The non-contact wide-angle viewing system can provide wide visual field for the vitreoretinal surgery in treating severe ocular trauma,decrease the influence of the ocular refractive media opacity and simplify the operative procedure.