显微镜下眼内容物剜除术127例临床分析  

Clinical analysis of evisceration under an operating microscope in 127 cases

作　　者：李辉[1] 庞永明[2] 

机构地区：[1]柳州市柳铁中心医院,中国广西壮族自治区545007 [2]北海市人民医院,中国广西壮族自治区536000

出　　处：《国际眼科杂志》2013年第9期1890-1892,共3页International Eye Science

摘　　要：目的:分析西非地区国家造成眼内容剜除的致病原因及相关因素,探讨127例127眼显微镜下眼内容剜除术的经验和体会。方法:回顾总结127例患者的病历资料,分析各种常见原因;所有患者均在手术显微镜下操作,并观察术后近期与远期并发症。结果:眼内容剜除的原因以角膜溃疡并发穿孔(114眼,89.8%)占首位,其中化脓性溃疡103眼(90.4%),Mooren氏溃疡5眼(4.4%),有34眼(29.8%)合并玻璃体化脓;严重眼球破裂伤因组织大范围缺损无法修补或脉络膜视网膜大部分脱出失去修补意义者(8眼,6.3%)占第2位,角膜葡萄肿并发症(5眼,3.9%)占第3位。术后近期并发症为眼睑与球结膜明显水肿97眼(76.4%),伤口活动性渗血2眼(1.6%);远期观察尚未发现交感性眼炎和结膜囊狭窄等并发症。结论:西非地区国家角膜感染性疾病常见,其化脓性角膜溃疡并发大穿孔是眼内容剜除术的最主要原因;在显微镜下操作可最大限度减少球结膜的撕裂缺损,有效避免脉络膜及色素的残留等,而这些缺点在传统肉眼下操作易发生。AIM： To analyze the main causes and related factors of evisceration in countries of western Africa, and study 127 cases （127 eyes） of the evisceration under an operating microscope. METHODS：The clinical records of 127 patients were analyzed retrospectively and causes and related factors were concluded. All cases of eviscerations were under an operating microscope, and the short and long term complications after operation were observed. RESULTS： The cause of the evisceration was mainly of perforation by corneal ulcer （114 eyes, 89.8%）, in which the purulent ulcer （103 eyes, 90.4%）,Moorens ulcer （5 eyes, 4.4%） and with vitreous purulence （34 eyes, 29.8%）. The secondary cause of the evisceration was the impossibility to repair because of the big tissue defect caused by severe rupture of eyeball and the lost significance of the repair because of the most prolapse of retina and choroid （8 eyes, 6.3%）. And the third cause was the complication of corneal staphyloma （5 eyes, 3.9%）. The short and long term complications after operation were visible edema of eyelid and conjunctiva （97 eyes, 76.4%） and active bleeding from operating incision （2 eyes, 1.6%）, and long term observation had not yet found the sympathetic ophthalmitis or narrow conjunctival sac as complications. CONCLUSION： The corneal infectious disease is common in western Africa and mainly causes by the large perforation with purulent corneal ulcer. The operation under surgery microscope can minimize the laceration and defection of bulbar conjunctiva and efficiently avoid the residual choroid and pigment, which could easily occur under traditional operation of the naked eye.

关 键 词：眼内容剜除术 角膜溃疡 角膜穿孔 显微手术操作 

分 类 号：R779.6[医药卫生—眼科]