外伤性睫状体分离综合治疗的临床研究

The experiences in comprehensive treatment of traumatic detachment of ciliary body

目的探讨外伤性睫状体分离临床综合治疗疗效分析。方法将125例经B超及眼科超声生物显微镜(UBM)及房角镜检查存在睫状体分离的患者根据病情不同选择不同的治疗方案。睫状体分离病变早期,睫状体分离范围(≤90°),行药物治疗和(或)睫状体光凝;药物及激光治疗失败,睫状体分离范围<180°的患者,屈光间质透明的患者,房角镜直视下行睫状体缝合复位术;屈光状态欠佳者行常规睫状体缝合复位术;睫状体分离范围>180°的患者行放射状巩膜切开点式缝合术;对于睫状体分离同时伴有玻璃体积血、视网膜脱离、脉络膜脱离等复杂性眼外伤患者,行玻璃体切除+睫状体复位术。观察术后视力、眼压及睫状体复位情况并进行统计分析。结果术后视力较术前有明显改善,眼压较术前显著提高差异均有统计学意义(P<0.05)。术后随访3~6个月,其中9例因份情过重,一期行眼内容摘除十人工骨植入术,116例患者通过UBM检查,其中109例睫状体复位成功,视网膜在位良好,手术成功率87.20%。结论外伤性睫状体分离个体化综合治疗效果可靠。

Objective To investigate the therapeutic effects of comprehensive treatment of traumatic detachment of ciliary body.Methods A total of 125 patients with traumatic detachment of ciliary body who were diagnosed by B ultrasound and UBM examination were enrolled in the study.The treatment schemes were selected according to patient’s condition.At early period of detachment of ciliary body,with its separation range being less than or equal to 90 DEG,the patients were treated by drug treatment or(and)cyclophotocoagulation,however,the patients whose separation range was less than 180 DEG,with refraction interstitium being transparent,were treated by incision point suture of ciliary body,moreover,the patients with separation range being less than 180 DEG were treated by radiated scleral incision point suture,and the patients with detachment of ciliary body complicated by vitreous hemorrhage,retinal detachment,choroidal detachment or complicated eye trauma,were treated by vitreous body resection+reduction of ciliary body.After treatment the postoperative visual acuity,intraocular pressure and ciliary body resetting status were observed and statistically analyzed.Results The postoperative visual acuity of patients was improved significantly,as compared with that before treatment(P<0.05),and the intraocular pressure was significantly improved(P<0.05).Among the 116 patients examined by UBM,the ciliary body resetting was successful in 109 cases,with surgical success rate being 87.20%.Conclusion The therapeutic effects of individualized comprehensive treatment on traumatic detachment of ciliary body are reliable.