玻璃体手术治疗复杂眼后段异物81例  

Vitreous surgery for complicated foreign bodies in the posterior segment in 81 cases

作　　者：杜红俊[1] 惠延年[1] 王琳[1] 王雨生[1] 

机构地区：[1]第四军医大学西京医院眼科全军眼科研究所,中国陕西省西安市710032

出　　处：《国际眼科杂志》2005年第1期115-117,共3页International Eye Science

摘　　要：目的:总结玻璃体手术治疗不同原因所致复杂眼后段异物的视力后果,分析受伤原因对视力的影响。方法:回顾性分析2001-01/2002-12经玻璃体手术治疗的复杂眼后段异物81例(87眼)的临床资料。按照受伤原因分为敲击伤36例(36眼)、爆炸伤37例(43眼)和其它外伤8例(8眼)引起的眼后段异物3组。结果:87眼均为复杂的眼后段异物。主要并发症包括外伤性白内障49眼,眼内炎9眼,视网膜脱离19眼,视网膜裂孔12眼,玻璃体积血43眼。玻璃体手术后:70眼(81%)视力提高,14眼(16%)视力不变,3眼(3%)视力下降;其中0.02以上40眼(46%),0.2以上34眼(39%)。术前无光感9眼中,4眼恢复光感以上视力。敲击伤和爆炸伤组术后的视力均好于术前的视力(P <0.05),敲击伤所致眼内异物的术后视力效果明显好于爆炸伤和其它原因所致眼内异物的视力(P <0.01)。结论:经过及时、恰当的玻璃体手术治疗,多数复杂的眼内异物的患者可得到相当的视力,其中敲击伤所致眼内异物效果较好。AIM: To summarize the visual outcome of patients with complicated foreign bodies in the posterior segment treated with vitreous surgery and to analyze the influence of different injuries on the visual outcome.· METHODS: Clinical data of 81 eyes(87 eyes) with complicated foreign bodies in the posterior segment treated with vitreous surgery from January 2001 to December 2002 were analyzed retrospectively. According to the causes of injury, the patients were divided into three groups: striking related foreign body (SFB, 36 cases, 36 eyes), explosion caused foreign body (EFB, 37 cases, 43 eyes) and other injury caused foreign body (OFB, 8 cases, 8 eyes).· RESULTS: Main complications included traumatic cataract in 49 eyes, endophthalmitis in 9 eyes, retinal detachment in 19 eyes, retinal tear in 12 eyes and vitreous hemorrhage in 43 eyes. Post-operatively, visual acuity (VA) improved in 70 eyes(81%), remained unchanged in 14 eyes(16%) and worsen in 3 eyes(3%). Forty (46%) acquired VA better than 0.02 and 34 eyes (39%) acquired VA better than 0.2. Among the 9 eyes without light perception before surgery, 4 had light perception or over. The postoperative VA of SFB and EFB groups were better than their preoperative VA(P < 0.05). The visual outcome of SFB group was better than those of EFB group and OFB group (P <0.01).· CONCLUSION: Most patients with complicated foreign bodies in the posterior segment can be salvaged with considerable VA after adequate and timely vitreous surgery. The visual outcome of SFB cases is better than those of other groups.·

关 键 词：治疗 眼后段异物 视力 玻璃体手术 爆炸伤 眼内异物 受伤原因 复杂 敲击 结论 

分 类 号：R779.6[医药卫生—眼科]