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成年患者外伤性视网膜脱离的一期玻璃体切除手术治疗

Surgical Management of Traumatic Retinal Detachment with Primary Vitrectomy in Adult Patients.

作者信息

Nowomiejska Katarzyna, Choragiewicz Tomasz, Borowicz Dorota, Brzozowska Agnieszka, Moneta-Wielgos Joanna, Maciejewski Ryszard, Jünemann Anselm G, Rejdak Robert

机构信息

Department of General Ophthalmology, Medical University of Lublin, Lublin, Poland.

Department of General Ophthalmology, Medical University of Lublin, Lublin, Poland; Department of Didactics and Medical Simulation, Human Anatomy Chair, Medical University of Lublin, Lublin, Poland.

出版信息

J Ophthalmol. 2017;2017:5084319. doi: 10.1155/2017/5084319. Epub 2017 Jan 9.

Abstract

To evaluate functional and anatomical results of pars plana vitrectomy (PPV) in the retinal detachment (RD) followed by severe eye trauma. Retrospective analysis of medical records of forty-one consecutive patients treated with 23-gauge PPV due to traumatic RD. Age, gender, timing of PPV, visual acuity, and presence of intraocular foreign body (IOFB) and proliferative vitreoretinopathy (PVR) were included in the analysis. Mean age of patients was 47 years; the majority of patients were men (88%). Closed globe injury was present in 21 eyes and open globe injury in 20 eyes (IOFB in 13 eyes, penetration injury in 4 eyes, and eye rupture in 3 eyes). Mean follow-up period was 14 months; mean timing of PPV was 67 days. Twenty-seven (66%) eyes had a functional success; 32 eyes (78%) had anatomical success. As a tamponade silicone oil was used in 33 cases and SF6 gas in 8 cases. Severe eye injuries are potentially devastating for vision, but vitreoretinal surgery can improve anatomical and functional outcomes. Among analysed pre- and intra- and postoperative factors, absence of PVR, postoperative retinal attachment, and silicone oil as a tamponade were related to significantly improved visual acuity.

摘要

评估严重眼外伤后视网膜脱离(RD)行玻璃体切割术(PPV)的功能和解剖学结果。回顾性分析41例因外伤性RD接受23G PPV治疗的连续患者的病历。分析内容包括年龄、性别、PPV手术时间、视力、眼内异物(IOFB)和增殖性玻璃体视网膜病变(PVR)的情况。患者平均年龄47岁;大多数患者为男性(88%)。21只眼为闭合性眼球损伤,20只眼为开放性眼球损伤(13只眼有眼内异物,4只眼为穿透伤,3只眼为眼球破裂)。平均随访期为14个月;PPV平均手术时间为67天。27只眼(66%)功能成功;32只眼(78%)解剖成功。33例使用硅油作为填塞物,8例使用SF6气体。严重眼外伤对视力可能具有毁灭性,但玻璃体视网膜手术可改善解剖和功能结果。在分析的术前、术中和术后因素中,无PVR、术后视网膜复位以及使用硅油作为填塞物与视力显著改善相关。

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