折叠式人工玻璃体球囊植入73例临床观察及体会

Clinical observation and perception of foldable capsular vitreous body implantation in 73 cases

目的:探讨折叠式人工玻璃体球囊植入术的手术方法,并对其治疗效果进行评价。方法:回顾性分析2018-04/2020-03于我院行人工玻璃体球囊植入手术治疗的严重眼球破裂伤及眼外伤玻璃体切除术后硅油依赖患者73例73眼。术后随访1~20mo,观察患者的视力、角膜、前房深度、眼压、眼底情况、人工玻璃体球囊状态及对外观满意度等。结果:本组患者73例均顺利完成手术,术中玻璃体球囊内硅油注入量2.4~4.2(平均3.5±0.36)mL。术后随访视力无光感22眼,光感及手动46眼,眼前指数5眼;角膜清亮或基本清亮19眼,角膜局限性混浊31眼,角膜灰白色明显混浊23眼;前房深度基本正常32眼,浅前房23眼,前房完全消失18眼;眼压由于角膜原因不能测试者22眼,眼压<8mmHg者17眼,眼压8~21mmHg者34眼;裂隙灯显微镜检查示人工玻璃体球囊位置均无明显偏位;对术后外观满意和基本满意者52例(71%);所有患者均未见球囊排斥、交感性眼炎及其他明显手术并发症。结论:折叠式人工玻璃体球囊植入治疗严重的眼球破裂伤和硅油依赖眼,可使患者免于眼球摘除,手术安全、有效,能够较好地维持眼球形态和眼内压。

AIM:To discuss the surgical method of foldable capsular vitreous body(FCVB)implantation and evaluate its therapeutic effect.METHODS:We retrospectively analysis of 73 cases with severe ocular rupture injury after FCVB implanted and silicone oil dependence after vitrectomy in our Hospital from April 2018 to March 2020.The visual acuity,corneal,anterior chamber depth,intraocular pressure,retina,FCVB status,their satisfaction with appearance is observed after treated from 1-20mo.RESULTS:All the 73 patients in this group were successfully operated.The amount of silicone oil injected into the FCVB during the operation was 2.4-4.2mL,with an average of 3.5±0.36mL.There were 22 eyes with light perception,46 eyes with manual perception and 5 cases with immediate index;19 eyes during postoperative follow-up.Corneal clarity or basic clarity was observed in 19 eyes,corneal local opacity in 31 eyes,and corneal grayish white opacity in 23 eyes.There were 32 eyes with normal anterior chamber,23 eyes with shallow anterior chamber,and 18 eyes with completely disappeared anterior chamber.The intraocular pressure(IOP)could not be tested in 22 eyes due to cornea,17 eyes with IOP less than 8mmHg,and 34 eyes with IOP between 8 and 21mmHg.Slit-lamp microscope examination showed no obvious deviation of the position of FCVB.The postoperative appearances were satisfactory and basically satisfactory in 52 eyes(71%).No balloon rejection,sympathetic ophthalmitis or other obvious surgical complications were observed in all cases.CONCLUSION:For the patients with severe eyeball rupture and silicone-oil-dependent eyes,the FCVB implantation can prevent from eyeball extraction.The operation is safe and effective,and the eyeball shape and intraocular pressure can be well maintained.