开放性眼外伤二期玻璃体手术的效果分析  

Effect and outcome of vitrectomy for treatment of open-globe injuries

作　　者：张凌[1] 刘勇[1] 陈少军[1] 黄小勇[1] 陈潇[1] 刘娜[1] 王一[1] 

机构地区：[1]第三军医大学西南医院眼科/西南眼科医院,重庆400038

出　　处：《中华眼外伤职业眼病杂志》2013年第4期267-270,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨开放性眼外伤二期介入玻璃体手术的临床疗效及影响因素。方法对二期玻璃体手术治疗的开放性眼外伤，排除眼内异物及外伤性眼内炎等需急诊玻璃体手术的病例，进行手术效果分析。结果104例（104眼）。分为两组，伤后10d内（包括10d）手术组计51例，10d以上手术组53例。10d内手术组最终视力提高3个等级的占53％（27／51），外伤性增生性玻璃体视网病变（TPVR）发生率为31．4％。伤后10d以上手术组视力提高3个等级的占30．2％，TPVR发生率为64．2％。发生TPVR的50例中效果不良的有10例占20％，无TPVR的54例中效果不良的有3例占5．5％。患者中伤及视网膜并睫状体脉络膜时TPVR发生率为63．3％，未伤及视网膜、脉络膜或者未同时伤及时TPVR发生率为34．5％。结论对于损伤重的开放性眼外伤，尤其是同时伤及视网膜及脉络膜的患者，为防止可能继发的TPVR对眼球产生的严重影响，应早期介入玻璃体手术。Objective To evaluate the clinical efficacy of vitrectomy surgery for open-globe inju- ries. Methods Retrospectively analyzed the data of patients with open-globe injuries treated from January of 2009 to May of 2012, except cases diagnosised as intraocular foreign body or traumatic endophthalmitis that need emergency vitrectomy. Results There are 104 eyes of 104 cases of open-globe injuries, been divided to two groups based on the time of vitrectomy after the injury, fifty-one patients received vitrectomy within ten days after the trauma, fifty-three patients received vitrectomy more than ten days after injury in other group, twenty-seven（53% ） patients best corrected visual acuity （BCVA） improved more than three levels in the group that had a vitrectomy within ten days after the injuries, sixteen（31.4% ） patients had traumatic prolif- erative vitreoretinopathy（TPVR） ;In the other group there were sixteen （30.2%） patients BCVA improved greatly, thirty-four patients had TPVR;Ten of fifty patients who appear TPVR had a poor prognosis, only three patients in fifty-four patients without TPVR had a poor prognosis;The incidence of TPVR was 63.3% （31/ 49） in the group that trauma implicate the retina and choroid. The incidence of TPVR was 34.5% （19/55） in the other group. Conclusion For patients with serious open-globe injuries of eyes, especially those reti- na and choroid injured the same time, in order to prevent the TPVR and other risk factors, they need a earlier vitrectomy.

关 键 词：眼外伤 开放性 玻璃体切除 二期手术 效果 

分 类 号：R779.6[医药卫生—眼科]