应用3D平视技术辅助玻璃体切除术治疗累及眼后节的眼外伤的临床研究  

Clinical study on the application of 3D head-up technology assisted vitrectomy in the treatment of ocular trauma involving posterior segment

作　　者：王新婷 樊芳芳 季苏娟 张正培 李甦雁 管莉娜 Wang Xinting;Fan Fangfang;Ji Sujuan;Zhang Zhengpei;Li Suyan;Guan Lina(Department of Ophthalmology,the Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University,the First People’s Hospital of Xuzhou,Xuzhou Eye Disease Research Institute,Xuzhou 221116,China)

机构地区：[1]徐州医科大学附属徐州市立医院眼科、徐州市第一人民医院、徐州市眼病防治研究所,徐州221116

出　　处：《中华眼外伤职业眼病杂志》2024年第5期334-340,共7页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：徐州科技项目基础研究计划(KC23016);徐州市卫生健康委科技创新项目(XWKYHT20230039);徐州市重点研发计划(KC23164)。

摘　　要：目的比较3D平视技术与传统显微镜下行玻璃体切除术治疗累及眼后节的眼外伤的临床效果及安全性。方法回顾性病例系列研究。纳入徐州市第一人民医院2020年1月至2022年12月玻璃体切除术治疗累及眼后节的眼外伤60例(60只眼)。按照手术方式不同分为两组,其中2020年1月至6月共21例(21只眼)采用传统显微镜下行玻璃体切除术者为传统显微镜组(对照组),2020年6月至2022年12月共39例(39只眼)采用3D平视技术下行玻璃体切除术者为3D平视技术组(观察组)。术后随访6个月,比较两组手术时长、术中眼内照明光强度、术后最佳矫正视力(BCVA,logMAR)、视网膜解剖复位率、术中及术后并发症发生率。结果对照组和观察组手术时长分别为75(68,110)min和60(50,80)min,差异有统计学意义(U=-2.57,P=0.010)。两组术中眼内照明光强度分别为52.00%(50.00%,53.00%)和26.00%(25.00%,29.00%),差异有统计学意义(Z=-6.37,P<0.001)。两组术后6个月BCVA分别为1.9(0.8,1.9)和1.7(0.7,2.3),均较术前2.3(1.0,2.3)和2.3(1.7,2.9)明显提高,差异均有统计学意义(Z=-2.03,-3.76;P=0.043,P<0.001);两组间术后BCVA比较,差异无统计学意义(t=-0.17,P=0.863)。两组术后视网膜解剖复位率分别为100.00%(21/21)和97.44%(38/39),差异无统计学意义(P=0.650)。两组间术中出血率、硅油注入率及术后角膜水肿、前房渗出、前房积血、高眼压及低眼压发生率对比,差异均无统计学意义(均P>0.05)。结论3D平视技术辅助下玻璃体切除术治疗累及眼后节的眼外伤可以达到与传统显微镜下相同的治疗效果,且能有效缩短手术时间,降低术中照明亮度。ObjectiveTo compare the clinical efficacy and safety of 3D head-up technique and traditional microscope in vitrectomy for the treatment of ocular trauma with posterior segment involvement.MethodsThis was a retrospective case-series study.A total of 60 eyes of 60 cases with posterior segment ocular trauma underwent vitrectomy in the First People’s Hospital of Xuzhou from Jan.2020 to Dec.2022 were collected.They were divided into two groups based on different surgical methods.Twenty-one cases(21 eyes)in the traditional microscope group underwent vitrectomy with traditional microscope from Jan.2020 to Jun.2020 as the control group,and 39 cases(39 eyes)in the 3D head-up technology group underwent vitrectomy with 3D head-up technology from Jun.2020 to Dec.2022 as the observation group.The follow-up duration was 6 months after surgery.Surgical duration,intraocular illumination intensity,best corrected visual acuity(BCVA,logMAR),anatomical reposition rate of retina,and incidence of intraoperative/postoperative complications were compared between the two groups.ResultsThe surgical duration in the control group and the observation group were 75(68,110)minutes and 60(50,80)minutes,respectively,the difference was statistically significant(U=-2.57,P=0.010).The intraocular illumination intensity of the two groups were 52.00%(50.00%,53.00%)and 26.00%(25.00%,29.00%)with statistically significant difference(Z=-6.37,P<0.001).BCVA was 1.9(0.8,1.9)in the control group and 1.7(0.7,2.3)in the observation group.Both groups showed significant improvement in BCVA at 6 months after surgery compared with that before surgery[2.3(1.0,2.3),2.3(1.7,2.9)](Z=-2.03,-3.76;P=0.043,P<0.001).There was no significant difference in postoperative BCVA between the two groups(t=-0.17,P=0.863).The anatomical reposition rate of retina was 100.00%(21/21)in the control group and 97.44%(38/39)in the observation group,with no statistically significant difference(P=0.650).Intraoperative bleeding rate,silicone oil injection rate,postoperative corneal edema,ant

关 键 词：玻璃体切除术 眼损伤 视敏度 3D平视技术 临床疗效 安全性 

分 类 号：R779.6[医药卫生—眼科]