中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
CHINESE JOURNAL OF OCULAR TRAUMA AND OCCUPATIONAL EYE DISEASE
2014年
8期
578-581
,共4页
眼挫伤%玻璃体积血%玻璃体切除术
眼挫傷%玻璃體積血%玻璃體切除術
안좌상%파리체적혈%파리체절제술
Contusion,ocular%Hemorrhage,vitreous%Vitrectomy
目的 观察玻璃体切除术治疗严重眼挫伤所致大量玻璃体积血的效果.方法 回顾性分析76例(76只眼)严重眼外伤所致大量玻璃体积血玻璃体切除术的术前及术后情况.结果 76只眼中术后视力提高者73只眼.术前无光感的4眼中术后仍无光感1只眼,光感2只眼,1只眼视力恢复至0.6.22只眼视网膜脱离者中,21只眼成功复位,复位率为95.45％.外伤性晶状体脱位28只眼,玻璃体术后一期人工晶状体植入5例.外伤性黄斑孔4只眼,3只眼玻璃体切除术中联合内界膜剥离,术后黄斑孔闭合.1例因黄斑区视网膜下大量积血,内界膜未剥离,孔未闭合,进行激光光凝,以防止孔周围视网膜脱离.结论 严重眼挫伤所致大量玻璃体积血,均可在外伤后及时进行玻璃体切除术治疗,对于术前无光感眼,当眼B超显示玻璃体团块状回声,未能分清视网膜及脉络膜结构者,需待玻璃体机化后,经过恰当的玻璃体切除术联合其他相应的治疗措施,大多能解剖治愈,部分患者可功能治愈.
目的 觀察玻璃體切除術治療嚴重眼挫傷所緻大量玻璃體積血的效果.方法 迴顧性分析76例(76隻眼)嚴重眼外傷所緻大量玻璃體積血玻璃體切除術的術前及術後情況.結果 76隻眼中術後視力提高者73隻眼.術前無光感的4眼中術後仍無光感1隻眼,光感2隻眼,1隻眼視力恢複至0.6.22隻眼視網膜脫離者中,21隻眼成功複位,複位率為95.45％.外傷性晶狀體脫位28隻眼,玻璃體術後一期人工晶狀體植入5例.外傷性黃斑孔4隻眼,3隻眼玻璃體切除術中聯閤內界膜剝離,術後黃斑孔閉閤.1例因黃斑區視網膜下大量積血,內界膜未剝離,孔未閉閤,進行激光光凝,以防止孔週圍視網膜脫離.結論 嚴重眼挫傷所緻大量玻璃體積血,均可在外傷後及時進行玻璃體切除術治療,對于術前無光感眼,噹眼B超顯示玻璃體糰塊狀迴聲,未能分清視網膜及脈絡膜結構者,需待玻璃體機化後,經過恰噹的玻璃體切除術聯閤其他相應的治療措施,大多能解剖治愈,部分患者可功能治愈.
목적 관찰파리체절제술치료엄중안좌상소치대량파리체적혈적효과.방법 회고성분석76례(76지안)엄중안외상소치대량파리체적혈파리체절제술적술전급술후정황.결과 76지안중술후시력제고자73지안.술전무광감적4안중술후잉무광감1지안,광감2지안,1지안시력회복지0.6.22지안시망막탈리자중,21지안성공복위,복위솔위95.45％.외상성정상체탈위28지안,파리체술후일기인공정상체식입5례.외상성황반공4지안,3지안파리체절제술중연합내계막박리,술후황반공폐합.1례인황반구시망막하대량적혈,내계막미박리,공미폐합,진행격광광응,이방지공주위시망막탈리.결론 엄중안좌상소치대량파리체적혈,균가재외상후급시진행파리체절제술치료,대우술전무광감안,당안B초현시파리체단괴상회성,미능분청시망막급맥락막결구자,수대파리체궤화후,경과흡당적파리체절제술연합기타상응적치료조시,대다능해부치유,부분환자가공능치유.
Objective To investigate the clinical efficacy of vitrectomy for vitreous hemorrhage caused by severe ocular contusion.Methods Vitrectomy was performed on 76 eyes of 76 patients with vitreous hemorrhage caused by severe ocular trauma.The preoperative and postoperative conditions of patients were retrospectively analysed.Results In 76 eyes,the postoperative visual acuity was improved in 73 eyes.In 4 eyes with no light perception,after surgery the visual acuity was still no light perception in 1 eye,light perception in 2 eyes and 0.6 in 1 eye.In 22 cases with retinal detachment,the retina was reattached successfully in 21 eyes and the reattachment rate was 95.45％.In 28 eyes with traumatic lens dislocation,the intraocular lens were implanted after vitrectomy in 5 eyes.In 4 eyes with traumatic macular hole,vitrectomy combined with internal limiting membrane peeling was performed in 3 cases and the hole was closed after surgery.The internal limiting membrane was not peeled and the hole was not closed in 1 eye because of macular subretinal massive hematocele.This patient was treated by laser treatment around the hole to prevent retinal detachment.Conclusion Vitrectomy can be performed timely for vitreous hemorrhage caused by severe ocular contusion.For the eyes with vision of no light perception,if the ultrasound examination reveals lumps echo in vitreous and the retina and choroid structure can not be distinguished,the proper vitrectomy combined with other treatments should be performed after the vitreous organization has formed.After these treatments,most patients can be cured anatomically and some patients can be cured functionally.
