严重眼后段外伤玻璃体手术中气液交换的应用.pdfVIP

中华跟外伤职业眼病杂志2015 年3 月第37 卷第3 期 Chin J Ocul Traum Occupat Eve Dis. Mar 2015. Vol. 37. No 3 • 161 • ·论著· 严重眼后段外伤玻璃体手术中气液 交换的应用 孟祥艳王文战 {摘要】 目的 探讨联合气液交换下玻璃体视网膜手术治疗严重眼后段外伤的临床效果。方 法 30 例(30 只眼)严重眼后段外伤，在联合气液交换下进行玻璃体视网膜手术，观察术中眼内操作 情况、手术时长、术前术后视力、视网膜和脉络膜复位情况及术后并发症。术后随访6 个月。结果 30 例玻璃体视网膜手术操作均在联合气液交换下顺利完成，术中止血效果佳，视野清晰，手术时间为 50 -90 min ，平均( 62.84 :t 10. 15) min。术后眼B 超检查，视网膜和脉络膜均复位。术后末次随访时 眼底检查，27 只眼视网膜复位佳，3 只眼复位不良。术后角膜水肿9 只眼，前房积血6 只眼，前房炎性 反应 13 只眼，继发性青光眼7 只眼，视网膜前或视网膜下增生26 只眼，硅油依赖眼8 只眼。术后视 力无光感2 只眼，光感4 只眼，手动 11 只眼，数指及以上 13 只眼，术后视力较术前显著提高，差异有 统计学意义(i =24. 79 ， P=0.0∞)。结论 采用联合气液交换下玻璃体视网膜手术提高了术中视野 清晰度，便于术中止血，顺利完成手术。并为严重眼后段外伤的进一步治疗创造了条件，避免了眼球 摘除。 [关键词】 玻璃体视网膜手术;视野;止血;气液交换 The application of fluid-air exchange during vitreoretinal s町gery for severe p侃侃rior segment ocular trauma Meng Xia昭yan ， Wang Wenzhan. Department 0/ Ophthalmology , The First Affiliated Hospital 0/ Zhengzhou University , Zhengzhou 450052 , China Corre句pondir啄 author: War电~ Wenzhan , Ernail: 189. cn [ Abstract 1 Objective To ev必uate the clinical outcomes of 由e vitreoretinal surgery combined wi由 fluid-air exchange for severe posterior segment ocular trauma. Methods Thirty eyes of 30 cases of severe posterior segment ocul町 trauma were involved in this study. Vitreoretinal s旧gery combined with fluid-air ex- change were perforrned on these eyes. The intraocular conditions during the surgeries , the operating time , the pre-and postoperative visual acuity , retinal and choroidal reattachment , and postoperative complications were recorded. The patients were followed up for 6 months. Results The operations of vitreoretinal surgery combined wi由 fluid-air exchange were perforrned successfully in all 30 eyes which provided effective condi- tion of hemostasis and clear s旧g