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内窥镜辅助平坦部玻璃体切除术治疗严重眼外伤。

Endoscope-assisted pars plana vitrectomy in severe ocular trauma.

机构信息

Vitreo Retinal Unit, Al Bahar Eye Hospital, Kuwait City, Kuwait.

出版信息

Br J Ophthalmol. 2012 Nov;96(11):1399-403. doi: 10.1136/bjophthalmol-2012-302187. Epub 2012 Sep 5.

Abstract

PURPOSE

To report the results of pars plana vitrectomy (PPV) assisted by ophthalmic endoscope (OE) in severe ocular trauma cases which are unsuitable for PPV using wide-angle contact/non-contact lens due to media haze and/or disorganised anterior segment.

METHODS

Prospective, non-comparative, interventional case series. Main outcome measured was anatomic status of the retina postoperatively, secondary outcome measured was functional status regarding vision, intraocular pressure and control of inflammation in cases of endophthalmitis.

RESULTS

Fifty trauma cases were included in the study. Out of these, 43 eyes had open globe injuries (32 eyes without intraocular foreign body (IOFB), and 11 eyes with retained IOFB), and seven eyes had post-traumatic endophthalmitis. In the open globe injury group, 36 (83.7%) eyes reported improvement in vision. In endophthalmitis group, five eyes showed improvement in vision.

CONCLUSIONS

OE provided a clear view to conduct PPV in select trauma cases where delay in surgery due to hazy media or due to non-availability of donor cornea for simultaneous penetrating keratoplasty can lead to severe proliferative vitreoretinopathy changes.

摘要

目的

报告在严重眼外伤病例中,由于混浊的眼内介质和/或前段组织紊乱,广角接触/非接触镜不适合行玻璃体切割术(PPV)时,采用眼科内窥镜(OE)辅助行 PPV 的结果。

方法

前瞻性、非对照、干预性病例系列研究。主要观察指标为术后视网膜解剖状态,次要观察指标为视功能、眼内压和眼内炎炎症控制情况。

结果

本研究共纳入 50 例外伤病例。其中,43 只眼为开放性眼球损伤(32 只眼无眼内异物(IOFB),11 只眼有 IOFB 残留),7 只眼为外伤性眼内炎。在开放性眼球损伤组中,36 只(83.7%)眼视力有所改善。在眼内炎组中,5 只眼视力有所改善。

结论

OE 提供了清晰的视野,使我们能够在一些选择的外伤病例中进行 PPV,这些病例由于混浊的眼内介质或供体角膜同时用于穿透性角膜移植术不可用而导致手术延迟,可能会导致严重的增生性玻璃体视网膜病变改变。

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