中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
2015年
2期
68-72
,共5页
封康%胡运韬%王常观%靳瑛%马志中
封康%鬍運韜%王常觀%靳瑛%馬誌中
봉강%호운도%왕상관%근영%마지중
眼损伤,穿透性%玻璃体切除术%眼外科手术%手术时机
眼損傷,穿透性%玻璃體切除術%眼外科手術%手術時機
안손상,천투성%파리체절제술%안외과수술%수술시궤
Eye injuries,penetrating%Vitrectomy%Ophthalmologic surgical procedures%Timing of surgery
目的 探索累及后节的开放性眼外伤玻璃体视网膜手术最佳时机.方法 系列病例研究.截至2009年12月,共有32例(32眼)眼球穿通伤开放Ⅲ区的病例从眼外伤玻璃体手术(EIVS)病例数据库中选定根据外伤发生至玻璃体视网膜手术的间隔时间(简称伤-术时间)分为3组:4～14 d组(12眼),15～28 d组(11眼),≥29 d组(9眼).评估手术时机对预后的影响,预后分为满意的视力预后(＞4/200)和不满意的视力预后(无光感～4/200),数据采用Kruskal-Wallis秩和检验和Spearman秩相关检验进行分析.结果 增殖性玻璃体视网膜病变(PVR)发生的可能性随着伤-术时间的增加而增大(r=0.622,P＜O.01).满意的视力结局眼在3组分别为9眼、4眼和1眼.Spearman秩相关分析显示,满意视力结局的可能性随着伤-术时间的增加而降低(r=-0.468,P＜0.01).4～14 d组和≥29 d组之间视力预后差异有统计学意义(P＜0.01).4～14 d组、15～28 d组和≥29 d组玻璃体手术后视力改善率分别为83.3％、45.5％和12.5％.视力改善率与伤-术时问之间呈负相关(r=-0.532,P＜0.01).结论 PVR发生的可能性随着伤-术时间的延长而增加.对累及后节的开放性眼外伤建议在伤后2周内行玻璃体视网膜手术.
目的 探索纍及後節的開放性眼外傷玻璃體視網膜手術最佳時機.方法 繫列病例研究.截至2009年12月,共有32例(32眼)眼毬穿通傷開放Ⅲ區的病例從眼外傷玻璃體手術(EIVS)病例數據庫中選定根據外傷髮生至玻璃體視網膜手術的間隔時間(簡稱傷-術時間)分為3組:4～14 d組(12眼),15～28 d組(11眼),≥29 d組(9眼).評估手術時機對預後的影響,預後分為滿意的視力預後(＞4/200)和不滿意的視力預後(無光感～4/200),數據採用Kruskal-Wallis秩和檢驗和Spearman秩相關檢驗進行分析.結果 增殖性玻璃體視網膜病變(PVR)髮生的可能性隨著傷-術時間的增加而增大(r=0.622,P＜O.01).滿意的視力結跼眼在3組分彆為9眼、4眼和1眼.Spearman秩相關分析顯示,滿意視力結跼的可能性隨著傷-術時間的增加而降低(r=-0.468,P＜0.01).4～14 d組和≥29 d組之間視力預後差異有統計學意義(P＜0.01).4～14 d組、15～28 d組和≥29 d組玻璃體手術後視力改善率分彆為83.3％、45.5％和12.5％.視力改善率與傷-術時問之間呈負相關(r=-0.532,P＜0.01).結論 PVR髮生的可能性隨著傷-術時間的延長而增加.對纍及後節的開放性眼外傷建議在傷後2週內行玻璃體視網膜手術.
목적 탐색루급후절적개방성안외상파리체시망막수술최가시궤.방법 계렬병례연구.절지2009년12월,공유32례(32안)안구천통상개방Ⅲ구적병례종안외상파리체수술(EIVS)병례수거고중선정근거외상발생지파리체시망막수술적간격시간(간칭상-술시간)분위3조:4～14 d조(12안),15～28 d조(11안),≥29 d조(9안).평고수술시궤대예후적영향,예후분위만의적시력예후(＞4/200)화불만의적시력예후(무광감～4/200),수거채용Kruskal-Wallis질화검험화Spearman질상관검험진행분석.결과 증식성파리체시망막병변(PVR)발생적가능성수착상-술시간적증가이증대(r=0.622,P＜O.01).만의적시력결국안재3조분별위9안、4안화1안.Spearman질상관분석현시,만의시력결국적가능성수착상-술시간적증가이강저(r=-0.468,P＜0.01).4～14 d조화≥29 d조지간시력예후차이유통계학의의(P＜0.01).4～14 d조、15～28 d조화≥29 d조파리체수술후시력개선솔분별위83.3％、45.5％화12.5％.시력개선솔여상-술시문지간정부상관(r=-0.532,P＜0.01).결론 PVR발생적가능성수착상-술시간적연장이증가.대루급후절적개방성안외상건의재상후2주내행파리체시망막수술.
Objective To evaluate the appropriate timing for vitrectomy in penetrating eye injuries involving the posterior segment.Methods Cases series study.Cases were selected from the database of the Eye Injury Vitrectomy Study (EIVS),which was a muhicenter cohort study established in 1997.Patients were classified into three groups based on the time that had elapsed between injury and vitreetomy:4-14 days,15-28 days and ≥29 days.Two main vision outcomes of injured eyes were assessed:favorable outcome (better than 4/200) and unfavorable outcome (no light perception -4/200).Data were analyzed using Kruskal-Wallis and Spearman.Results There were 12,11 and 9 cases in the 4-14 days,15-28 days and ≥29 days groups,respectively.There were no statistically significant differences in age,BCVA after injury,scleral wound,ciliary body damage,retinal detachment,or choroid damage among the three groups.The probability of the incidence of proliferative vitreoretinopathy (PVR) increased following an increase in the interval between the injury and vitrectomy (r=0.622,P＜0.01).Favorable vision outcomes were 9 cases,4 cases and 1 case in the three respective groups.The probability of a favorable vision outcome decreased following an increase in the interval between the injury and vitrectomy (r=-0.468,P＜0.01).The Fisher exact test showed that visual outcomes from penetrating eye injuries involving the posterior segment that were treated with vitrectomy 4-14 days after injury were better than vitrectomies performed ≥29 days (P＜0.01).Vision improvement rate was negative correlated with interval between the injury and vitrectomy (r=-0.532,P＜0.01).Conclusion The probability of PVR inc reased with a greater lapse in time.Thorough vitrectomy should be performed on patients no later than 14 days after open-globe injury.
