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[内镜辅助玻璃体切除术治疗无光感严重外伤性眼的疗效评估]

[Evaluation of endoscopy assisted vitrectomy for the treatment of severe traumatic eyes with no light perception].

作者信息

Ren Hui, Jiang Rui, Xu Gezhi, Chang Qing, Lyu Jiahua, Chen Qinyuan, Wang Wenji

机构信息

Department of Ophthmology, Eye and Ear Nose Throat Hospital, Fudan University, Shanghai 200031, China.

Department of Ophthmology, Eye and Ear Nose Throat Hospital, Fudan University, Shanghai 200031, China. Email:

出版信息

Zhonghua Yan Ke Za Zhi. 2014 Mar;50(3):194-6.

Abstract

OBJECTIVE

To evaluate the effect of endoscopy assisted pars plana vitrectomy for severe ocular trauma with no light perception.

METHODS

A retrospective case-series study. Medical records of 6 eyes of 6 patients undergoing endoscopy assisted vitrectomy for severe ocular trauma with no light perception from December 2006 to August 2009 were studied. Four patients were male and 2 patients were female. Their age ranged from 6 to 67 years old with an mean age of 38 years. History of trauma, visual acuity prior to vitrectomy and at final follow-up, bacterial culture results and surgical approaches were recorded.

RESULTS

Visual acuity prior to vitrectomy was no light perception in all the 6 patients with a mean intraocular pressure of 3 mmHg (1 mmHg=0.133 kPa) . All the patients had diffuse corneal edema along with opacities caused by corneal perforation from trauma in 3 patients, blood staining of cornea in 2 patients and endophthalmitis in 1 patient. B-scan ultrasound echography carried out before surgery showing that all the patients had retinal detachment. Three patients' vitreous samples were sent for bacterial culture. Bacillus cereus, S.epidermidis and Aeromonas Hydrophila were identified respectively. Patients were followed up for 18 to 36 months. Postoperatively, 5 of the patients' visual acuity was better than light perception, ranging from light perception to 0.04. The retina was reattached in 4 patients.

CONCLUSION

Endoscopy assisted vitrectomy is a safe and effective option for the treatment of severe traumatic eye with no light perception.

摘要

目的

评估内镜辅助下经平坦部玻璃体切除术治疗无光感的严重眼外伤的效果。

方法

一项回顾性病例系列研究。对2006年12月至2009年8月期间6例因严重眼外伤无光感而接受内镜辅助玻璃体切除术的患者的6只眼的病历进行研究。4例为男性,2例为女性。年龄范围为6至67岁,平均年龄38岁。记录外伤史、玻璃体切除术前及最终随访时的视力、细菌培养结果及手术方式。

结果

6例患者玻璃体切除术前均无光感,平均眼压为3 mmHg(1 mmHg = 0.133 kPa)。所有患者均有弥漫性角膜水肿,3例患者因外伤导致角膜穿孔伴有混浊,2例患者角膜血染,1例患者发生眼内炎。术前B超检查显示所有患者均有视网膜脱离。3例患者的玻璃体样本进行了细菌培养,分别鉴定出蜡样芽孢杆菌、表皮葡萄球菌和嗜水气单胞菌。患者随访18至36个月。术后,5例患者的视力优于光感,范围从光感到0.04。4例患者视网膜复位。

结论

内镜辅助玻璃体切除术是治疗无光感的严重外伤性眼的一种安全有效的选择。

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