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42例创伤性环形睫状体脉络膜脱离的手术治疗

Surgical treatment for 42 patients with traumatic annular ciliochoroidal detachment.

作者信息

Yang Jian-Gang, Yao Guo-Min, Li Shao-Peng, Ren Bai-Chao

机构信息

Department of Ophthalmology, the Affiliated Hospital of Xi'an Medical University, Xi'an 710077, Shaanxi Province, China.

出版信息

Int J Ophthalmol. 2011;4(1):81-4. doi: 10.3980/j.issn.2222-3959.2011.01.19. Epub 2011 Feb 18.

Abstract

AIM

To analyze the clinical features of traumatic annular ciliochoroidal detachment (CCD) with ultrasound biomicroscopy (UBM) images, to investigate the surgical outcomes of ciliary body suturing and the prognostic factors.

METHODS

Forty-two patients with traumatic annular CCD who had undergone ciliary body suturing were enrolled for complete ocular examinations, including visual acuity (VA), slitlamp microscopy, tonometer, indirect ophthalscopy and UBM. Comparisons of clinical features were performed among baseline and follow-ups, and the morphologic alterations on UBM images were analyzed between pre- and post-surgery.

RESULTS

The mean intraocular pressure (IOP) was 5.54mmHg, and the median VA was 0.1 in traumatic eyes at baseline. The pre-surgical morphological features on UBM images consisted of supraciliochoroidal effusion (33.33%), multilayer splits (40.48%) and CCD with cyclodialysis cleft (26.19%). After surgery, the median VA was 0.4 at the final follow-up. IOPs were significantly increased, which the mean final IOP was to 10.36mmHg (P<0.01). UBM images displayed complete reattachment in 40.48% of patients, partial reattachment in 50.00% of patients and 360-degree detachment in 9.52% of patients. Analyzing the prognostic factors, the significant factors were duration, VA at baseline, ocular laterality (P<0.01), gender, age and the presence of hypotonous maculopathy (P<0.05).

CONCLUSION

Ciliary body suturing is the optimized procedure for traumatic annular CCD. UBM is a useful equipment for diagnosis and monitoring post-surgical morphological changes. The periodical detection of IOP and UBM is necessary for the observation of surgical outcomes.

摘要

目的

通过超声生物显微镜(UBM)图像分析外伤性环形睫状体脉络膜脱离(CCD)的临床特征,探讨睫状体缝合术的手术效果及预后因素。

方法

纳入42例行睫状体缝合术的外伤性环形CCD患者,进行全面的眼部检查,包括视力(VA)、裂隙灯显微镜检查、眼压测量、间接检眼镜检查和UBM检查。对基线和随访时的临床特征进行比较,并分析手术前后UBM图像上的形态学改变。

结果

外伤性眼基线时平均眼压(IOP)为5.54mmHg,中位视力为0.1。UBM图像上术前形态学特征包括睫状体上腔积液(33.33%)、多层劈裂(40.48%)和伴有睫状体分离的CCD(26.19%)。术后最终随访时中位视力为0.4。眼压显著升高,最终平均眼压升至10.36mmHg(P<0.01)。UBM图像显示40.48%的患者完全复位,50.00%的患者部分复位,9.52%的患者360度脱离。分析预后因素,显著因素为病程、基线视力、眼别(P<0.01)、性别、年龄和低眼压性黄斑病变的存在(P<0.05)。

结论

睫状体缝合术是外伤性环形CCD的优化手术方法。UBM是诊断和监测术后形态学变化的有用设备。定期检测眼压和UBM对于观察手术效果是必要的。

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