眼内镜下玻璃体切除术治疗伴角膜混浊的严重眼外伤的疗效观察  

Evaluation of endoscopy assisted vitrectomy for the treatment of severe traumatic eyes with no light perception

作　　者：任慧[1] 江睿[1] 徐格致[1] 常青[1] 吕嘉华[1] 陈钦元[1] 王文吉[1] 

机构地区：[1]复旦大学附属眼耳鼻喉科医院眼科, 上海200031

出　　处：《中华眼科杂志》2014年第3期194-196,共3页Chinese Journal of Ophthalmology

摘　　要：目的 探讨眼内镜下玻璃体切除术治疗严重眼外伤无光感眼的效果.方法 回顾性系列病例研究.回顾性分析2006年12月至2009年8月在复旦大学附属眼耳鼻喉科医院眼科接受眼内镜下玻璃体切除手术的6例严重眼外伤无光感眼患者的临床资料,其中男性4例,女性2例;年龄6～67岁,平均38岁.记录患者外伤方式及时间、术前及最后一次随访的视力、培养结果及手术方式.结果 所有患者术前视力均为无光感,平均眼压为3 mmHg（1 mmHg=0.133 kPa）.3例有角膜穿孔伤导致的混浊,2例患者角膜血染,1例因为合并严重的眼内炎导致角膜混浊明显;术前B超提示所有患者均有视网膜脱离.3例玻璃体送检标本细菌培养阳性,其中细菌培养蜡样芽孢杆菌1例,表皮葡萄球菌1例,嗜水气单孢菌1例.患者随访18～ 36个月,5例患者恢复光感以上视力,BCVA为光感至0.04.视网膜复位4只眼（4/6）.结论 眼内镜下玻璃体切除术可以较为安全有效地治疗严重眼外伤无光感眼,使视力得到一定提高.Objective To evaluate the effect of endoscopy assisted pars plana vitrectomy for severe ocular trauma with no light perception.Methods A retrospective case-series study.Medical records of 6 eyes of 6 patients undergoing endoscopy assisted vitrectomy for severe ocular trauma with no light perception from December 2006 to August 2009 were studied.Four patients were male and 2 patients were female.Their age ranged from 6 to 67 years old with an mean age of 38 years.History of trauma,visual acuity prior to vitrectomy and at final follow-up,bacterial culture results and surgical approaches were recorded.Results Visual acuity prior to vitrectomy was no light perception in all the 6 patients with a mean intraocular pressure of 3 mmHg（1 mmHg =0.133 kPa）.All the patients had diffuse corneal edema along with opacities caused by corneal perforation from trauma in 3 patients,blood staining of cornea in 2 patients and endophthalmitis in 1 patient.B-scan ultrasound echography carried out before surgery showing that all the patients had retinal detachment.Three patients＆#39; vitreous samples were sent for bacterial culture.Bacillus cereus,S.epidermidis and Aeromonas Hydrophila were identified respectively.Patients were followed up for 18 to 36 months.Postoperatively,5 of the patients＆#39; visual acuity was better than light perception,ranging from light perception to 0.04.The retina was reattached in 4 patients.Conclusion Endoscopy assisted vitrectomy is a safe and effective option for the treatment of severe traumatic eye with no light perception.

关 键 词：眼损伤 角膜混浊 玻璃体切除术 内窥镜检查 治疗结果 

分 类 号：R779.6[医药卫生—眼科]