Ghoraba Hammouda Hamdy, Mansour Hosam Osman, Heikal Mohamed Amin, Abdelfattah Hitham Mammon, Elgemai Emad Mohamed
*Tanta University; †Magrabi Eye Hospital; ‡Al-Azhar University; §Banha University; ¶Banha Teaching Hospital; and **Damanhour Teaching Hospital.
Retina. 2016 Mar;36(3):596-602. doi: 10.1097/IAE.0000000000000739.
To evaluate whether omitting the use of the 360° episcleral band in combination with pars plana vitrectomy and silicone oil tamponade had an effect on either anatomical or functional success in cases of perforating eye injury due to gunshot.
A retrospective consecutive interventional study from medical records. Surgeries were performed in the period from January 2011 until the end of December 2013. Patients with perforating eye injury due to gunshots were treated with pars plana vitrectomy and silicone oil tamponade with or without the addition of a 360° scleral band.
Two hundred and thirteen eyes of 210 patients were reviewed of which 17 patients were excluded, 5 patients because the vision had no light perception and 12 patients because of the short follow-up period (less than 6 months). The remaining 196 eyes of 193 patients were analyzed. All surgeries were performed by 1 surgeon. The included eyes have been classified into 2 groups; 101 eyes in the first group (360° band was used), and 95 eyes in the second group (without 360° band). The included patients were followed up at least 6 months after the last surgery. By first surgery, anatomical success was achieved in 93 eyes (92.08%) in Group 1, and retinal detachment developed in 8 eyes (7.92%). In Group 2 anatomical success was achieved in 91 eyes (95.78%), and retinal detachment developed in 4 eyes (4.21%). All cases with retinal detachment were reattached by second surgery. In the first group, visual acuity improved in 80 eyes (79.2%), unchanged in 14 eyes (13.86%), and was less than that of preoperative value in 7 eyes (6.93%). In the second group visual acuity improved in 78 eyes (82.1%), unchanged in 13 eyes (13.68%) and less than that of preoperative value in 4 eyes (4.21%). No statistically significant difference was found between the two groups (P = 0.943) in anatomical or functional results. None of the operated eyes developed phthisis bulbi.
The abundant use of the 360° scleral band in combination with pars plana vitrectomy and silicone oil tamponade did not change the anatomical or the functional outcomes in the management of perforating eye injury due to gunshots.
评估在因枪伤导致的眼球穿孔伤病例中，在玻璃体切割联合硅油填充术时不使用360°巩膜环扎带是否对解剖学或功能学上的成功有影响。
一项基于病历的回顾性连续干预研究。手术于2011年1月至2013年12月期间进行。对因枪伤导致眼球穿孔伤的患者进行玻璃体切割联合硅油填充术，术中使用或不使用360°巩膜环扎带。
对210例患者的213只眼进行了回顾，排除了17例患者，5例因视力无光感，12例因随访时间短（少于6个月）。对其余193例患者的196只眼进行了分析。所有手术均由1名外科医生完成。纳入的眼分为2组；第一组101只眼（使用360°环扎带），第二组95只眼（未使用360°环扎带）。纳入的患者在最后一次手术后至少随访6个月。第一次手术后，第一组93只眼（92.08%）取得解剖学成功，8只眼（7.92%）发生视网膜脱离。第二组91只眼（95.78%）取得解剖学成功，4只眼（4.21%）发生视网膜脱离。所有视网膜脱离病例均通过二次手术复位。第一组中，80只眼（79.2%）视力提高，14只眼（13.86%）视力不变，7只眼（6.93%）视力低于术前值。第二组中，78只眼（82.1%）视力提高，13只眼（13.68%）视力不变，4只眼（4.21%）视力低于术前值。两组在解剖学或功能学结果上均未发现统计学显著差异（P = 0.943）。所有手术眼均未发生眼球痨。
在因枪伤导致的眼球穿孔伤的治疗中，大量使用360°巩膜环扎带联合玻璃体切割和硅油填充术并未改变解剖学或功能学结果。
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