早期玻璃体切割术治疗开放性眼外伤合并眼后节受累的临床效果

The Effect of the Early Vitrectomy for Open Ocular Trauma Combined with Oculi Posterior Segment Involvement

目的探讨早期玻璃体切割术治疗开放性眼外伤合并眼后节受累的临床效果。方法回顾性分析我院2015年2月~2017年3月64例开放性眼外伤合并眼后节受累患者临床资料,根据患者行玻璃体切割手术时间分为一周内行手术治疗组即早期玻璃体切割术组(观察组,30例),8~30 d内行手术治疗组即非早期玻璃体切割术组(对照组,34例)。比较两组患者术后患眼视力恢复情况、视网膜复位率、手术成功率、外伤性增殖性玻璃体视网膜病变(proliferative vitreoretinopathy,PVR)发生情况及术后并发症发生率。结果术后观察组患眼视力恢复情况、视网膜复位率及手术成功率明显高于对照组,PVR发生率明显低于对照组,差异均有统计学意义(P<0.05);而两组并发症发生率比较,无统计学差异(P>0.05)。结论开放性眼外伤合并眼后节受累患者早期行玻璃体切割术有利于视力恢复及视网膜复位,并且提高了手术成功率,减少了外伤性PVR的发生率。

Objective To investigate the effect of early vitrectomy in the treatment of open ocular trauma combined with posterior segment involvement. Methods The clinical data of 64 cases suffered open ocular trauma with posterior segment involvement in our hospital from February 2015 to March 2017 were analyzed retrospectively. According to the surgical opportunity, they were divided into the observation group （performed vitrectomy within one week, n=30） and the control group （performed vitrectomy within 8 to 30 days, n=34）. The recovery of visual acuity, retinal reattachment rate, the success rate of surgery, traumatic proliferative vitreoretinopathy （PVR） and incidence rate of postoperative complications were compared between the two groups after the operation. Results After the surgery, the recovery of visual acuity, retinal reposition rate and the operation success rate of the observation group were significantly higher than those of the control group, and the incidence of PVR was significantly lower than that of the control group, and all the differences were statistically （ P 〈0.05）. There was no statistical difference in complication rate between two groups （ P 〉0.05）. Conclusion The early vitrectomy is beneficial to vision recovery and retinal reattachment, and it can increase the success rate of surgery and decrease the incidence of traumatic PVR for open ocular trauma with posterior segment involvement.