30G针头辅助下连续褥式缝合治疗外伤性睫状体离断

Clinical observation of continuous mattress repairing for cyclodialysis cleft using a 30-gauge straight needle

目的探讨30G针头辅助下连续褥式缝合治疗外伤性睫状体离断的有效性及安全性。方法收集2014年7月至2018年7月我院眼外伤科收治的外伤性睫状体离断患者12例(12眼),均行30G针头辅助下连续褥式缝合。观察角膜及前房反应情况,比较手术前后患者最佳矫正视力、眼压等,并利用超声生物显微镜观察手术后睫状体组织复位情况。结果 12例患者均成功实施30G针头辅助的睫状体连续褥式缝合术,术后睫状体均复位,最佳矫正视力、眼压均得到不同程度提高,术前眼压为(6.46±1.08)mmHg(1 kPa=7.5 mmHg),术后1周、1个月眼压分别为(16.50±4.97)mmHg、(14.58±4.00)mmHg,均较术前明显提高,差异均有统计学意义(t=-7.47、-6.81,均为P<0.05)。术后随访3~12个月,未出现线结外露、缝线松脱、角膜内皮失代偿、交感性眼炎、眼内炎、脉络膜脱离等并发症。结论 30G针头辅助下连续褥式缝合治疗外伤性睫状体离断安全有效,手术操作简单,组织损伤小,并发症少。

Objective To evaluate the efficacy and safety of continuous mattress repairing for traumatic cyclodialysis cleft using a 30-gauge straight needle.Methods Totally 12 patients with traumatic cyclodialysis cleft were observed from July 2014 to July 2018 in ocular trauma department of our hospital.All the clefts were closed by continuous mattress repairing using a 30-gauge straight needle.Patients were followed up for cornea and anterior chamber condition,best-corrected visual acuity(BCVA) and intraocular pressure(IOP).The cyclodialysis cleft site was observed by ultrasound biomicroscopy(UBM) postoperatively.Results All cyclodialysis cleft sites were successfully repaired using a 30-gauge straight needle.No bleeding or suture breakage were observed during surgery.All the cyclodialysis cleft sites were successfully closed after surgeryconfirmed by UBM.Visual acuity was improved to different degrees.IOP was significant elevated after surgery.The mean IOP was(6.46±1.08)mmHg(1 kPa=7.5 mmHg) preoperatively,while it was(16.50±4.97)mmHg one week postoperatively and(14.58±4.00)mmHg one month postoperatively.Comparing with IOP preoperatively,both the differences were statistically significant(t=-7.47,-6.81,all P<0.05).Patients’ postoperative follow-up period was 3 to 12 months.No significant complications(such as suture knots exposing,suture loosening,cornea endothelial decompensation,sympathetic ophthalmia,endophthalmitis and choroid detachment) were occurred during follow-up period.Conclusion Continuous mattress repairing using a 30-gauge straight needle was a safe and effective procedure with simple operation,little tissue damage and few complications.