外伤性无光感眼救治观点和方法的改变

Transition in the treatment viewpoint and method for injured eyes with no light perception

探查性玻璃体切除手术(EPPV)可使1/4的外伤性无光感(NLP)眼获救.过去临床常规依据伤情评估和初步观察决定NLP眼是否摘除眼球,而EPPV可发现NLP眼的内部情况,这些发现可为救治NLP眼开辟新的途径.本文通过阐述NLP眼无光感的病理基础以及EPPV的优势和作用,提出由EPPV决定是否摘除眼球应成为临床治疗NLP眼新的常规方法.

Exploratory pars plana vitrectomy (EPPV) made one quarter of injured eyes with no light perception (NLP) rescued. Previously, the clinical routine in making a decision of enucleation for injured eyes with NLP was based on preoperative evaluation. Such ideas, however, have altered with development of EPPV. Some extraordinary lesions can be explored in those moribund eyes during EPPV and dealt with newly developed techniques. This article reveals the pathological basis of traumatized NLP eyes and the advantages and effects of EPPV, and puts forward the concept that decision making of enucleation should be based on findings obtained during EPPV.