Guillaume J B, Godde-Jolly D, Haut J, Monin C, Ruellan Y M
Service d'Ophtalmologie du Pr Hamard, CHNO des Quinze-Vingts, Paris.
J Fr Ophtalmol. 1991;14(5):311-9.
The clinical features and results of surgical management of 68 out of a series of 101 cases of traumatic retinal detachment in childhood are described and analysed. Follow-up, in particular after the removal of silicon oil used temporarily, was always been longer than six months. Cases were divided into three groups: contusions, ocular injuries without foreign body and with foreign body. Cases of retinal detachment related to traumatic aphakia, severe myopia and associated with proliferative vitreo-retinopathy were also studied. The prognosis of retinal detachment in childhood, the main characteristics of which are late diagnosis and the early and rapid growth of proliferative vitreo-retinopathy appears to be worse in this series than usually published figures. Proliferative vitreo-retinopathy is the leading cause of surgical failure. The long term retinal reattachment rate did not exceed fifty per cent and the functional success rate was only thirty-three per cent. It is for this reason that the authors wish to emphasize the need for the provision of information to families and to ophthalmologists responsible for the management of these "high risk eyes". It is felt that the most complete surgery possible should be performed at the outset when proliferative vitreo-retinopathy exists.
本文描述并分析了101例儿童外伤性视网膜脱离病例中的68例的临床特征及手术治疗结果。随访时间,尤其是在临时使用的硅油取出后,均超过6个月。病例分为三组:挫伤、无异物眼外伤和有异物眼外伤。还研究了与外伤性无晶状体、高度近视相关以及伴有增生性玻璃体视网膜病变的视网膜脱离病例。儿童视网膜脱离的预后,其主要特征为诊断延迟以及增生性玻璃体视网膜病变早期快速发展,在本系列研究中似乎比通常公布的数据更差。增生性玻璃体视网膜病变是手术失败的主要原因。长期视网膜复位率不超过50%,功能成功率仅为33%。因此,作者希望强调向负责管理这些“高危眼”的家庭和眼科医生提供信息的必要性。认为当存在增生性玻璃体视网膜病变时,应在一开始就尽可能进行最完善的手术。