眼球钝挫伤致视网膜脱离的临床观察

Retinal detachment due to ocular contusion

目的 观察眼球钝挫伤所致视网膜脱离的临床特点及手术预后。 方法 对本院 1999年1月～ 2 0 0 2年 1月收治的 36例 36只眼钝挫伤所致视网膜脱离患者的临床资料进行了回顾性分析。 结果 本组病例巨大裂孔 (≥ 90°) 3只眼 (8.3% ) ,其中 2只眼裂孔位于颞侧偏上方 ,1只眼仅有鼻下方视网膜相连 ;锯齿缘离断 4只眼 (11.1% ) ;黄斑裂孔 4只眼 (11.1% ) ;未发现裂孔的增生性玻璃体视网膜病变(PVR)视网膜脱离 3只眼 (8.3% ) ;其他部位的裂孔 (<90°) 2 2只眼 (6 1.2 % ) ,其中颞侧近周边部裂孔 9只眼 (2 5 .0 % ) ,鼻侧近周边部裂孔 5只眼 (14 .0 % ) ,近后极部裂孔 8只眼 (2 2 .2 % )。 36只眼均有不同程度的PVR,PVRC1以下 14只眼 (38.8% ) ,PVRC1或以上 2 2只眼 (6 1.2 % ) ,其中 C1～ C311只眼 (30 .6 % ) ,D1～D2 2 7只眼 (19.5 % ) ,D3者 4只眼 (11.1% )。从外伤到视网膜脱离的间隔时间最短为 1d,最长为 2 2个月 ,以 1～ 8周为常见 (6 9.4 % )。 32只眼 (88.8% ) ,手术后视网膜完全复位 ;手术前后视力经统计学处理 ,差异有显著性的意义 (χ2 =2 7.174 ,P<0 .0 0 1)。 结论 眼球钝挫伤所致视网膜脱离常伴有不同程度的增生性玻璃体视网膜病变 ,从外伤到视网膜脱离的间隔时间长短不一。与眼球钝挫伤有?

Objective To find out about the characteristics and prognosis of retinal detachment due to ocular contusion. Methods The clinical data of 36 patients (36 eyes) with retinal detachment due to ocular contusion were retrospectively analyzed. Results There were 3 eyes (8.3%) with huge retinal hole (≥90°), 4 eyes (11.1%) oral tear of ora serrata retinae, 4 eyes (11.1%) with macular hole, 3 eyes (8.3%) with tractive retinal detachment, and 22 eyes (61.2%) with retinal hole (<90°) at other positions (including temporal peripheral hole in 9, nasal peripheral hole in 5, and posterior polar hole in 8). Proliferative vitreoretinopathy (PVR) was found in all patients with <C1 in 14 (38.8%) and ≥C1 in 22 eyes (61 2%) (including C1-3 in 11, D1-2 in 7, and D3 in 4). The interval from ocular contusion to retinal detachment was 1 day-22 months, the most common period is 1 week-8 weeks (69.4%). Complete restoration was found in 32 eyes (88.8%) after the operation. Final best-corrected visual acuity of post-operation was better than that of pre-operation ( P<0.001) . Conclusions Retinal detachment due to ocular contusion often go with PVR. The interval from contusion to retinal detachment varies from days to months. Visual prognosis can be good when retinal detachment is diagnosed and treated in time.