山东大学耳鼻喉眼学报

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伴睫状体脱离的复杂眼外伤联合手术27例

温 莹,张建华,毕宏生   

  1. 山东中医药大学眼科中心 山东施尔明眼科医院, 济南 250002
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2008-10-16 发布日期:2008-10-16
  • 通讯作者: 毕宏生

Surgeries for 27 cases of ocular trauma complicated with ciliary body detachment

WEN Ying, ZHANG Jian-hua, BI Hong-sheng   

  1. Ophthalmic Center, Shandong University of Traditional Chinese Medicine,
    Shandong Shierming Eye Hospital, Jinan 250002, China
  • Received:1900-01-01 Revised:1900-01-01 Online:2008-10-16 Published:2008-10-16
  • Contact: BI Hong-sheng

摘要: 目的评价睫状体复位联合玻璃体切割在治疗伴有睫状体脱离的复杂眼外伤中的临床疗效。方法严重眼外伤患者27例,超声生物显微镜(UBM)探查所有外伤眼睫状体360°全周脱离,离断口的范围在3~5个钟点。术前视力光感~眼前手动,平均眼压(6.03±3.25)mmHg。伴随症状包括轻度角膜血染、外伤性扩瞳、前房积血、虹膜根部离断、晶状体脱位或半脱位、外伤性白内障、玻璃体混浊、视网膜脱离、脉络膜脱离等。所有患眼施行玻璃体切割联合睫状体修补术,其它操作包括晶状体切除、虹膜离断口修补、视网膜复位或巩膜外穿刺放液等。结果术后UBM显示所有患眼睫状体复位。所有外伤眼术后视力较术前明显提高。术后1月平均眼压(19.33±5.05)mmHg。24眼(88.89%)屈光间质清晰,所有患眼随访期间视网膜、脉络膜在位。结论对于睫状体离断口范围超过2个钟点的复杂眼外伤患者,玻璃体视网膜手术联合睫状体修补术可有效恢复眼球的解剖结构,并保存有效的的视功能。

关键词: 眼外伤, 睫状体脱离, 联合手术

Abstract: To evaluate the clinical effect of vitrectomy and cyclodialysis cleft repair for ocular trauma complicated with ciliary body detachment. Methods27 cases of complicated ocular trauma were subjected to ultrasound bio-microscopy (UBM) for determining ciliary body detachment, which was 360 degrees associated with the cyclodialysis of 3 to 5 o′clock. Pre-operative visual acuity (VA) ranged from light perception (LP) to hand movement (HM). The average intraocular pressures(IOP) was 6.03±3.25mmHg before surgeries. Also blood staining of cornea, mydriasis, hyphema, detachment of the iris root, luxation or semiluxation of the lens, traumatic cataract, vitreous opacity and detachment of the retina or choroids were found. Repair of the cyclodialysis cleft combined with vitrectomy was performed on all patients, and also cataract removal, iris root suture, retina re-attachment and sclera tapping were performed. ResultsAfter surgeries, the ciliary body reattached in all cases. Post-operative VA was significantly improved. The mean IOP was 19.33±5.05 mmHg at 1 month. During the follow-up, no detachment of the retina was found and the refracting media of 24 eyes(88.89%)remained clear. ConclusionFor ocular trauma with the cyclodialysis above 2 o′clock, combined vitrectomy and repair of the cyclodialysis cleft are effective to recover the anatomic structure and preserve the available visual function.

Key words: Cyclodialysis, Combined surgery, Ocular trauma

中图分类号: 

  • R772.2
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