前段玻璃体切割在复杂眼外伤手术中的应用  

Application of anterior vitrectomy in complicated ocular trauma

作　　者：陈吉婷 李学喜 王志军[2] 

机构地区：[1]解放军180医院眼科医院,全军创伤救治中心,福建省泉州市362000 [2]解放军总医院眼科,全军眼科中心,北京市100853

出　　处：《眼科新进展》2011年第5期464-467,共4页Recent Advances in Ophthalmology

摘　　要：目的探讨前段玻璃体切割术在复杂性眼前段、后段外伤手术中的效果。方法选择我院资料完整的眼外伤住院病例86例（86眼）,均行前部玻璃体切割术。其中开放性眼球外伤53眼、钝挫伤性晶状体脱位19眼、外伤性白内障合并前后囊膜破裂伴玻璃体脱入前房14眼,均采用前段玻璃体切割器切除前房破碎的晶状体及脱出的玻璃体,或超声乳化联合前段玻璃体切割术。其中12眼合并后段病变行玻璃体视网膜手术联合C3F8气体或硅油填充术。术后随诊648个月（平均15个月）。结果 76眼较术前视力提高;57眼植入人工晶状体,其中54眼位置居中。开放性眼外伤53眼眼球破裂经Ⅰ期缝合、前段玻璃体切割处理,其中28眼Ⅱ期植入人工晶状体,矫正视力0.150.50;13眼未植入人工晶状体,矫正视力0.020.10;12眼经玻璃体视网膜手术处理后,视网膜复位,保留了眼球。晶状体脱位19眼、外伤性白内障合并后囊膜破裂伴玻璃体脱出14眼,术后矫正视力〈0.1者2眼,0.10.3者7眼,0.30.5者10眼,0.5以上者14眼。结论前段玻璃体切割手术在处理复杂眼外伤有较好的效果,为人工晶状体植入或玻璃体视网膜手术创造条件。Objective To evaluate the efficacy of anterior vitrectomy in the complicated anterior or/and posterior segment of traumatized eyes.Methods The anterior vitrectomy was performed in 86 patients（86 eyes）with complicated ocular trauma in our hospital.Anterior vitreous cutter or phacoemulsification combined with anterior vitrectomy was used in 53 eyes with open ocular trauma,19 eyes with traumatic lens dislocation,14 eyes with traumatic cataract rupture and vitreous prolapse into anterior chamber.The vitreoretinal surgery combined with C3F8 or silicone oil filling surgery was used in 12 eyes with posterior diseases.The follow up was from 6 months to 48 months（mean 15 months）.Results The postoperative visual acuity improved in 76 eyes,the intraocular lens（IOL）were implanted in 57 eyes,the positions of IOL were well in 54 eyes.After surgerying primarily and anterior vitreous cutting in 53 eyes with ocular rupture,28 eyes were implanted with IOL lately and the postoperative best corrected visual acuity（BCVA）was from 0.15 to 0.50,13 eyes were not impanted with IOL and the postoperative BCVA was from 0.02 to 0.10,12 eyes had retinal reattachment and maintained eyeball-shape after timely vitreoretinal surgery.In 19 eyes with traumatic lens dislocation,14 eyes with traumatic cataract combined with posterior capsule rupture and vitreous prolapse into anterior chamber,the postoperative BVCA was less than 0.1 in 2 eyes,from 0.1 to 0.3 in 7 eyes,from 0.3 to 0.5 in 10 eyes,more than 0.5 in 14 eyes.Conclusion Anterior vitrectomy is very effective for the complicated ocular trauma,improves the implanting rate of IOL or vitreoretinal surgery possibly.

关 键 词：前段玻璃体切割 眼外伤 视力 

分 类 号：R779.1[医药卫生—眼科]