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儿童眼前段和眼后段联合伤:综述。

Combined anterior and posterior segment injuries in children: a review.

机构信息

University Eye Hospital, University of Leipzig, Liebigstrasse 10-14, Leipzig, Germany.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2010 Sep;248(9):1207-19. doi: 10.1007/s00417-010-1414-x. Epub 2010 May 29.

Abstract

BACKGROUND

Combined anterior and posterior segment injuries in children require special attention to the unique characteristics of children's eyes, including a pronounced tendency to scar formation and proliferation, adherence of the posterior vitreous, as well as the danger of amblyopia.

METHODS

This article reviews the current body of literature documenting the main aspects of surgical management, complications, and prognosis of combined anterior and posterior segment injuries in children.

RESULTS

For optimal treatment success, special strategies are necessary with regard to: 1) comprehensive secondary operation for internal reconstruction, 2) encircling buckle surgery, 3) management of the lens, 4) use of a temporary keratoprosthesis, 5) endophthalmitis, and 6) late complications, e.g., secondary glaucoma, secondary strabismus, leukoma cornea, and phthisis bulbi. Further crucial prognostic factors were analyzed.

CONCLUSION

Combined anterior and posterior segment injuries in children require optimal surgical treatment management that varies from adult treatment with regard to several essential aspects. Care should be provided by pediatric ophthalmology specialists with orthoptic follow-up as necessary, over many years.

摘要

背景

儿童的眼前段和眼后段联合损伤需要特别注意儿童眼睛的独特特征,包括明显的瘢痕形成和增殖倾向、玻璃体后粘连以及弱视的危险。

方法

本文综述了目前有关儿童眼前段和眼后段联合损伤的手术治疗、并发症和预后的主要文献。

结果

为了获得最佳的治疗效果,需要采取特殊的策略,包括:1)全面的二期内重建手术,2)环扎带手术,3)晶状体的处理,4)临时角膜替代物的应用,5)眼内炎,以及 6)晚期并发症,如继发性青光眼、斜视、角膜白斑和眼球萎缩。进一步分析了关键的预后因素。

结论

儿童的眼前段和眼后段联合损伤需要优化的手术治疗管理,在几个重要方面与成人治疗不同。需要由儿科眼科专家进行治疗,并根据需要进行多年的斜视随访。

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