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采用微小切口玻璃体切除术成功治疗开放性眼球损伤所致外伤性视网膜脱离1例

Successful Management in a Case of Traumatic Retinal Detachment due to Open Globe Injury Using Microincisional Vitrectomy.

作者信息

Lai Wei-Yu, Wu Tsung-Tien

机构信息

Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, and National Yang-Ming University School of Medicine, Kaohsiung, Taiwan.

出版信息

Case Rep Ophthalmol. 2016 Oct 11;7(3):198-202. doi: 10.1159/000450638. eCollection 2016 Sep-Dec.

Abstract

BACKGROUND

Retinal detachment (RD) following ocular trauma often results in guarded visual prognosis and sometimes leads to loss of the eye. With the advent of microincisional vitrectomy surgery and the development of surgical techniques, the management of ocular trauma has been transformed.

CASE PRESENTATION

A 34-year-old man sustained an open globe injury from fragmented glass at work. He received primary repair and another follow-up surgery 9 days later, including vitrectomy, silicone oil tamponade, and lensectomy for RD and traumatic cataract at another medical center. However, his retina was totally detached and completely curled up in a roll with choroid on display when he was seen by us 1 month later. He was managed with vigilant and patient peeling and unfolding of the retina using a 23-gauge forceps and silicone oil tamponade, and achieved anatomical success and preservation of his eye at 6-month follow-up.

CONCLUSIONS

This report demonstrates that even in cases which appear to be hopeless at presentation, the surgeon's perseverance and surgical technique can salvage an eye that may otherwise be phthisical. It also encourages retinal surgeons to use microincisional vitrectomy to manage severe traumatic RD.

摘要

背景

眼外伤后视网膜脱离(RD)常导致视力预后不佳,有时甚至导致眼球丧失。随着微小切口玻璃体切除术的出现和手术技术的发展,眼外伤的治疗发生了变革。

病例介绍

一名34岁男性在工作时因玻璃碎片导致开放性眼球损伤。他接受了一期修复,并在9天后在另一家医疗中心接受了后续手术,包括玻璃体切除术、硅油填充和晶状体切除术,以治疗视网膜脱离和外伤性白内障。然而,1个月后我们见到他时,他的视网膜完全脱离并完全卷曲成一卷,脉络膜暴露在外。我们使用23号镊子小心翼翼且耐心地对视网膜进行剥离和展开,并进行硅油填充,在6个月的随访中实现了解剖学成功并保住了他的眼球。

结论

本报告表明,即使在初诊时看似无望的病例中,外科医生的毅力和手术技术也可以挽救原本可能萎缩的眼球。它还鼓励视网膜外科医生使用微小切口玻璃体切除术来治疗严重的外伤性视网膜脱离。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c21b/5216252/7f1acb674137/cop-0007-0198-g01.jpg

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