玻璃体切除手术治疗严重眼外伤临床效果分析  

Analysis of the clinical effect of vitrectomy in the treatment of severe ocular trauma

作　　者：余天 覃远君 张帆[2] YU Tian;QIN Yuanjun;ZHANG Fan(Department of Ophthalmology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430000,China;Department of Orthopaedics,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430000,China)

机构地区：[1]华中科技大学同济医学院附属同济医院眼科,湖北武汉430000 [2]华中科技大学同济医学院附属同济医院骨科,湖北武汉430000

出　　处：《中国医药科学》2020年第6期276-279,共4页China Medicine And Pharmacy

摘　　要：目的 探讨玻璃体切除重硅油眼内充填治疗眼外伤的临床疗效.方法 选取本院2008年12月~2011年12月收治的眼外伤患者60例(60眼),全部给予玻璃体切除重硅油眼内充填治疗,观察本组患者的临床疗效情况.结果 所有经术后随访,在随访期眼球全部保留50例(占83.33%),眼球萎缩10例(占16.67%),术后20例患者视力达到(0.01~0.05),20例为数指,10例手动,5例光感,仅5例无光感.50例患者在随访期间眼部情况稳定,没有出现严重术后并发症,全部没有取出充填的硅油,10例眼球萎缩患者,再次进行眼球摘除手术并且装入义眼座.经随访,出现炎症反应10例(占16.67%),白内障5例(占8.33%),虹膜萎缩10例(占16.67%),术后高眼压10例(占16.67%),最高达50mm Hg,经青光眼药物治疗均降到21mm Hg以下),低眼压5例(占8.33%),废用性斜视5例(占8.33%).60眼球内异物均成功取出,其13眼伴化脓性眼内炎,11例眼炎症控制,2例巨大异物的眼内炎患者,角膜混浊严重,脉络膜视网膜出血,网膜巨大裂孔伴视网膜脱离,术后眼内炎仍不能控制而摘除眼球.结论 使用玻璃体切除重硅油眼内充填治疗眼外伤,不但可以保留患者眼球的完整,也可以有效提高患者的视力,值得临床推广使用.Objective To explore the clinical effect of vitrectomy and heavy silicone oil intraocular filling in the treatment of ocular trauma.Methods 60 patients(60 eyes)with ocular trauma were selected from December 2008 to December 2011.All patients were treated with vitrectomy and intraocular filling with heavy silicone oil.The clinical effect of this group of patients were observed.Results All patients were followed up,during the follow-up period,50 cases(83.33%)of eyeball were preserved,10 cases(16.67%)had atrophy of eyeball.The visual acuity of 20 patients was 0.01-0.05,20 cases were digital fingers,10 cases were manual,5 cases were light sensitive,only 5 cases were no light sensitive.During the follow-up period,the eyes of 50 patients were stable,no serious postoperative complications occurred,and no silicone oil was taken out,10 patients with atrophy of the eyeball were treated by enucleation again and put into the orbital implant.After follow-up,10 cases(16.67%)had inflammatory reaction,5 cases(8.33%)had cataract,10 cases(16.67%)had iris atrophy,10 cases(16.67%,up to 50 mm Hg,which was reduced to less than 21 mm Hg after glaucoma drug treatment)had high intraocular pressure,5 cases(8.33%)had low intraocular pressure and 5 cases(8.33%)had disused strabismus.All the foreign bodies in 60 eyes were successfully removed,including 13 eyes with suppurative endophthalmitis,11 eyes with inflammation control,in 2 cases of endophthalmitis with huge foreign body,the cornea was turbid seriously,chorioretinal hemorrhage,retinal detachment accompanied by giant retinal hole,and the eyeball was removed because the endophthalmitis could not be controlled.Conclusion The use of vitrectomy and heavy silicone oil in the treatment of ocular trauma can not only preserve the integrity of the eyes of patients,but also effectively improve the vision of patients,which is worthy of clinical application.

关 键 词：玻璃体切除 重硅油 眼内充填 眼外伤 

分 类 号：R779.6[医药卫生—眼科]