复杂性角膜穿通伤的联合手术治疗

Combined Surgery for Complicated Corneal Penertrating Trauma

目的探讨复杂性角膜穿通伤联合手术治疗的效果。方法对本院近 3年来收住院的复杂性角膜穿通伤病人 96例 (96只眼 )进行手术治疗 ,其中 72例作联合手术 ,另 2 4例作分期手术。将两组病例术后平均 1 8.5个月视力进行比较分析。结果经术后 3个月至 3年 (平均 1 8.5个月 )的随访 ,联合手术组术后矫正视力大于 0 .1者 61例 ,占 84.7% ,大于 0 .3者共 49例 ,占 68.1 %。 1 2例穿透性角膜移植联合其他手术的病人 ,其移植片保持透明共 1 1例 ,透明成功率为 91 .7%。分期手术组术后矫正视力大于0 .1及 0 .3者分别为 1 9例及 1 1例 ,分别占 79.2 %及 45 .8%。经统计学处理后两组结果均无显著性差异 (P >0 .0 5 )。结论①联合手术可使复杂性角膜穿通伤病人尽快恢复或提高视力 ,缩短了疗程。②联合手术与分期手术比较术后视力无显著性差异 ,鉴于前者具有其他优点 ,故是一种值得推荐的治疗方法。③联合玻璃体切除术的应用 ,减少了术中、术后并发症 。

Objective To explore the method and effect of combined surgery on complex penertrationg trauma.Methods 96 cases of complex perforating corneal trauma were reported, including all patients who underwent combined and sequential surgeries between 2000 and 2002. Among them, 72 cases underwent combined surgery and 24 sequential surgery. Visual outcome are reported with detailed analysis for both series.Results After the follow up for an average of 18.5 months, 61(84.7%) eyes had a visual acuity of at least 0.1, 49(68.1%) had visual 0.3 in combined surgery group; 19 eyes (79.2%) had 0.1 or better,11 eyes (45.8%) had 0.3 or better.Corrected postoperative visual acuity in the combined surgery group was the same as in the sequential surgery group (P>0.05).Conclusion The combined surgery for complex perforating corneal trauma has been proved successful,producing good visual result and causing no sight-threatening complications.It could be a good option in selected cases.