严重Ⅲ区开放性眼外伤玻璃体切除联合手术的效果

Vitrectomy combined surgery for the treatment of severe Ⅲ zone open ocular trauma

目的评价25G玻璃体切除联合手术治疗严重的Ⅲ区开放性眼外伤的效果。方法对严重的Ⅲ区开放性眼外伤41例（4l眼）的临床资料进行回顾性分析，患者均于伤后5—7d接受25G玻璃体切除术联合白内障摘出、视网膜脱离复位、视网膜切开、增生膜剥除术以及硅油填充。对术前术后最佳矫正视力进行比较分析。结果所有患者均为巩膜全层裂伤达角膜缘后6．0～19．0mm，平均（9．4±2．6）mm。术后视力提高者27眼（65．85％）。其中术前无光感的9眼术后仍无光感者3眼，光感2眼，手动4眼。术前有明确视网膜脱离的38眼中视网膜完全复位34眼（89．47％），视网膜部分复位4眼（10．53％）。另3眼因损伤过于严重，眼内结构絮乱而无法进行修复手术。结论玻璃体切除联合手术可以有效治疗严重的Ⅲ区开放性眼外伤，并能恢复一定的视功能。

Objective To evaluate the efficacy of 25 G vitrectomy combined surgery for the treatment of severe Ⅲ zone open ocular trauma. Methods The clinical data of 41 eyes of 41 cases with severe Ⅲ zone open ocular trauma were collected and analyzed retrospectively. All cases underwent 25 G vitrectomy combined with cataract extraction, retinal detachment reduction, retinal incision, proliferating membrane peeling, scleral buckling surgery and silicone oil tamponade in 5-7 days after ocular trauma. The preoperative and postoperative best corrected visual acuity were compared and analyzed. Results Ocular trauma sclera full-thickness laceration of all eases were 6.0-19.0 mm behind corneal limbus, average （9.4±2.6） ram. Postoperative visual acuity was improved in 27 eyes （65.85%）. Among 9 eyes without light sensation before operation, after surgery there was 3 eyes still no light sensation, light senses in 2 eyes and hand movement in 4 eyes. Among 3g eyes with retinal detachment before surgery, the retinal completely reattaehment was in 34 eyes （89.47%）, and partial reattaehment of the retina was in 4 eyes （ 10.53% ）. The other 3 eyes were not able to perform restorative surgery due to too severe injury and the intraocular structural flocculation. Conclusion Vitrectomy combined surgery can effectively treat severe HI zone ocular trauma, the visual function will be restored.