复杂眼球穿通伤二期玻璃体手术临床分析

Vitrectomy for Treatment of Complicated Open-Globe Injuries of Eyes

目的 分析复杂性眼球穿通伤救治过程中各手术阶段的特点 ,强调伤眼救治的时序性。方法 对我院 1998年 1月～ 2 0 0 2年 1月间收治的开放性眼外伤二期进行玻璃体切割手术的 5 6例 (5 8眼 )进行回顾性分析。结果 伤眼经二期玻璃体手术后 ,最终视力提高 4 4眼 (75 9% ) ,视力保持不变 9(15 5 % ) ,视力下降 5眼 (8 6 % ) ;伤眼一期伤口修复满意的视力预后明显好于不满意的 ;伤后 2周左右实施玻璃体切割手术的视力预后明显好于其他时间段 ,伤后超过 1月进行玻璃体切割手术的伤眼视力预后最差。结论 复杂性眼球穿通伤显微手术的一期修复水平决定着伤眼的命运 ,准确把握二期玻璃体切割手术时机 ,使外伤眼的救治具有系统性 。

Objective To analyze the characteristic of treatment of complicated open globe injuries of eyes in several periods and to emphasize the time limiting of treatment for traumatic eyes. Methods The vitrectomy of complicated open globe injuries of 58 eyes wea retrospectively analyzed. Results After virectomy, 44 eyes (75.9%) got better visual acuity; and the traumatic eyes which wounds were sutured satisfactorily in the first period got better visual acuity than not satisfactorily. The traumatic eyes which vitrectomy in the second period was performed in about 2 weeks got better visual acuity than in other times. If the vitrectomy in the second period was performed beyond 1 month, the prognosis of visual acuity of traumatic eyes was the worst. Conclusion The quality of suturing in the first period decide the fate of complicated open globe injuries of eyes. The time limiting is very important for the traumatic eyes which were performed virectomy in the second period.