改良睫状体缝合复位术与传统睫状体缝合复位术临床比较研究

A clinical study of improved cyclopexy with tradltional direct cyclopexy

目的评价改良睫状体缝合复位术与传统睫状体缝合复位术治疗外伤性睫状体离断的临床效果，为优化手术方案提供依据。方法临床病例对照研究。取2012年9月至2014年2月间于天津市眼科医院手术治疗的外伤性睫状体离断患者23例，分为2组。传统组11例，改良组12例，传统组行传统睫状体缝合复位术，改良组行改良睫状体缝合复位术，即巩膜瓣下小切口放液行连续缝合复位方法。比较两组术后睫状体复位情况、眼压及视力，进行统计分析，评价疗效。结果传统和改良睫状体缝合复位术术后复位率分别为90．9％（10／11）、100％（12／12），两组复位率比较差异无统计学意义（P〉0．05）。两组术后2周时眼压较术前均有明显回升，差异均有统计学意义（传统组t=-12．34，P〈0．01：改良组t=-11．85，P〈O．01），但两组问比较差异无统计学意义（t=-1．17，P〉0．05）。两组术后2周时视力与术前比较明显改善，差异均有统计学意义（传统组t=-5．27，P〈0．01；改良组t=-5．89，P〈0．01），但两组间比较差异无统计学意义（t=-1．06，P〉0．05）。结论传统的睫状体缝合复位术和改良的睫状体缝合复位术均能有效复位睫状体，眼压、视力等指标均有改善，但改良术式较传统术式操作相对简化，应用范围更宽，效果确切。

Objective To evaluate the clinical effects of an improved cyclopexy and the tradition- al cyclopexy in the treatment for traumatic cyclodialysis and provide a basis for optimizing surgical options. Methods A randomized controlled clinical study. Twenty-three patients receiving operation for traumatic cyclodialysis in Tianjin Eye Hospital were randomly divided into 2 groups. The tradi- tional group had 11 cases, and the improved group 12 cases. The traditional group underwent the tra- ditional direct cyclopexy surgery while the improved group receiving an improved cyclopexy surgery. Restoration of ciliary body, preoperative and postoperative intraocular pressure and visual acuity were recorded, and statistical analysis was made. Results After operation, 90.9% （10/11） patients in the traditional group and 100% （12/12） patients in the improved group successfully reset the ciliary body, which had significant difference in statistical significance compared with that of preoperative （P 〈0.05）, but there was no statistical significance between the two groups postoperatively （P 〉0.05）. IOP and visual acuity were increased respectively on average 2 weeks after operation in both groups. The difference in both groups had statistical significance （P 〈0.05）, but there was no statisti- cal significance between the two groups postoperatively （P 〈0.05）. Conclusions Both the traditional direct cyclopexy and the improved cyclopexy can effectively reset ciliary body with intraocular pres- sure and visual acuity improvement, but the latter is relatively simplified, time saving and it is hopefully getting more applications in more cases.