严重眼外伤中瞳孔成形手术的病例研究

A case-series study on coreoplasty in severe eye injuries

目的分析严重眼外伤患者中瞳孔成形手术的应用现状，并探讨其在防止发生硅油前房异位中的作用。方法临床病例系列研究。对2013年12月31日在眼外伤玻璃体手术研究（eye injury vitrectomy study，EIVS）数据库中选取伴虹膜缺损的严重眼外伤病例（245例），分析瞳孔成形手术构成比，并比较未瞳孔成形组与瞳孔成形组硅油前房异位发生率的差异。采用，检验。结果在EIVS数据库1377例严重眼外伤病例中，虹膜缺损245例（17．8％），其中瞳孔成形手术76例（31．0％）。在128例伴虹膜缺损的硅油眼中，未瞳孔成形组发生硅油前房异位14例（16．3％），瞳孔成形组发生1例（2．4％），二者构成比差异具有统计学意义（x^2=5．269，P=0．021）。结论对于伴有虹膜缺损的严重眼外伤，瞳孔成形手术率有待进一步提高。对于伴有虹膜缺损的硅油眼患者，瞳孔成形手术是减少发生硅油前房异位的有效措施。

Objective To evaluate the application of coreoplasty in severe eye injuries. Investigatethe role of coreoplasty in silicone oil eyes with iris defects in preventing the prolapse of silicon oil into the anterior chamber. Methods In this case-series study, severe eye injury cases with iris defects were selected from Eye Injury Vitrectomy Study （EIVS） database. The proportion of co- reoplasty surgery was analyzed and the differences between the non-coreoplasty group and coreoplas- ty group in the incidence of silicon oil efflux into the anterior chamber were compared. Data were analyzed using g2 test. Results Information of 1377 eyes in the EIVS database was explored, 245 cases （17.8%） showed traumatic iris defects and overall 76 eyes （31.0%） were undergone coreoplas- ty. In 128 silicon oil tamponated eyes with iris defects, the analysis revealed silicon oil efflux into the anterior chamber to be significantly more frequent in non-coreoplasty group （g2=5.269, P=0.021）. Conclusions In severe eye injuries with iris defects, the coreoplasty surgery should be more wide- ly performed. In silicon oil eyes with iris defects, coreoplasty surgery could be advantage to mini- mize the risk of silicon oil efflux into the anterior chamber.