开放性眼外伤玻璃体手术后硅油依赖多因素分析:眼外伤玻璃体手术研究  

Risk factors of silicon oil dependent after pars plana vitrectomy in open globe injuries:Eye Injury Vitrectomy Study

作　　者：陆宛 封康[2] 王奇骅 王冰洁[1] 孙彤 马志中[2] 胡运韬[1] Lu Wan;Feng Kang;Wang Qihua;Wang Bingjie;Sun Tong;Ma Zhizhong;Hu Yuntao(Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102200,China;Peking University Third Hospital,Peking University Ophthalmology Center,Beijing 100083,China)

机构地区：[1]清华大学附属北京清华长庚医院眼科清华大学临床医学院,北京102200 [2]北京大学第三医院北京大学眼科中心,北京100083

出　　处：《中华眼底病杂志》2025年第4期277-281,共5页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的观察并初步分析开放性眼外伤(OGI)玻璃体切割手术(PPV)后硅油依赖的相关危险因素。方法回顾性临床研究。眼外伤玻璃体手术研究数据库中2005年1月1日至2016年12月31日接受PPV治疗且临床资料完整的OGI患者211例211只眼纳入研究。硅油依赖定义为患眼PPV后6个月硅油填充状态下眼压<10 mm Hg(1 mm Hg=0.133 kPa)。详细记录患者年龄、眼压、损伤类型、眼球巩膜伤口长度以及是否存在睫状体、脉络膜损伤和视网膜缺损。应用logistic多因素回归模型分析年龄、眼球巩膜伤口长度以及睫状体、脉络膜损伤和视网膜缺损与硅油依赖的相关性。结果211例患者年龄32.93(1~73)岁。手术后随访时间为20.06(5.85~90.58)个月。211只眼中,破裂伤、穿通伤、眼内异物伤、贯通伤分别为121(57.3%,121/211)、52(24.6%,52/211)、23(10.9%,23/211)、15(7.1%,15/211)只眼。硅油依赖98只眼(46.4%,98/211)。其中,破裂伤、穿通伤、眼内异物伤、贯通伤分别为64(65.3%,64/98)、19(19.4%,19/98)、9(9.2%,9/98)、6(6.1%,6/98)只眼。相关性分析结果显示,PPV后硅油依赖与睫状体损伤[比值比(OR)=2.150,95%可信区间(CI)1.052~4.393]、脉络膜损伤(OR=3.233,95%CI 1.454~7.191)、视网膜缺损(OR=2.731,95%CI 1.393~5.353)显著相关(P<0.05);与年龄(OR=0.981,95%CI 0.960~1.002)、眼球巩膜伤口长度(OR=1.716,95%CI 0.987~2.984)无关(P>0.05)。结论OGI患眼PPV后发生硅油依赖与睫状体、脉络膜损伤及视网膜缺损相关;与年龄、眼球巩膜伤口长度无关。Objective To observe and preliminarily analyze the risk factors related to silicone oil dependence after pars plana vitrectomy(PPV)in open globe injuries(OGI).Methods A retrospective clinical study.This study included 211 patients with OGI who received PPV treatment from January 1,2005 to December 31,2016 in Eye Injury Vitrectomy Study database.Silicone oil dependence was defined as the intraocular pressure<10 mm Hg(1 mm Hg=0.133 kPa)in silicone oil tamponade eye 6 months after PPV.The patient's age,intraocular pressure,type of injury,length of eyeball wound,as well as the presence of ciliary body injury,choroidal injury,and retinal resection and/or defect area were recorded in detail.Logistic multifactorial regression analyzed the correlation between age,eye wound length and ciliary body iinjury,choroidal injury and retinal resection and/or defect severity and silicone oil dependence.Results 211 OGI eyes underwent vitrectomy were included,the mean age of the study population was 32.93 years(range 1-73 years),and the median follow-up period was 20.06 months(range 5.85-90.58 months).Among the 211 eyes,121(57.3%,121/211),52(24.6%,52/211),23(10.9%,23/211)and 15(7.1%,15/211)were rupture,perforation,intraocular foreign bodies and penetrating injury,respectively.98 eyes(46.4%,98/211)of silicone oil dependence in total,among them,64(65.3%,64/98),19(19.4%,19/98),9(9.2%,9/98)and 6(6.1%,6/98)eyes were rupture,perforation,intraocular foreign body and penetrating injury,respectively.Correlation analysis revealed that silicone oil dependence was significantly associated with ciliary body injury[odds ratio(OR)=2.150,95%confidence interval(CI)1.052-4.393],choroidal injury(OR=3.233,95%CI 1.454-7.191),and retinal injury(OR=2.731,95%CI 1.393-5.353).No correlation was found with age(OR=0.981,95%CI 0.960-1.002)or ocular wound length(OR=1.716,95%CI 0.987-2.984)(P>0.05).Conclusion Silicone oil dependency following PPV in OGIs are associated with ciliary body,choroidal,and retinal injuries,but no association with age or length of the o

关 键 词：开放性眼外伤 硅油依赖 睫状体损伤 脉络膜损伤 视网膜缺损 

分 类 号：R779.6[医药卫生—眼科]