Russell S R, Olsen K R, Folk J C
Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami, FL 33101.
Am J Ophthalmol. 1988 Mar 15;105(3):253-7. doi: 10.1016/0002-9394(88)90005-0.
We reviewed retrospectively 40 eyes that had received blunt trauma and had been explored for scleral rupture. Twenty-nine eyes had scleral rupture. Of these 29, ten had ruptures seen preoperatively. Nineteen had occult ruptures. The preoperative findings predictive of scleral rupture were a visual acuity of light perception or no light perception, an intraocular pressure of less than 10 mm Hg, hyphema, and chemosis. Of the 29 ruptures, 27 involved the superior hemisphere and 25 involved the anterior hemisphere of the globe. Ten of 29 eyes (34%) with scleral rupture and eight of 11 eyes (73%) without rupture achieved a final visual acuity of 5/200 or better over an average follow-up period of 6.7 months. Factors prognostic of ambulatory vision for eyes with ruptured and intact globes included an initial visual acuity of 5/200 or better, absence of scleral rupture, and a rupture length of less than 11 mm in eyes with ruptures. The vitrectomized eyes also had a better result, suggesting that early pars plana vitrectomy is of benefit in selected rupture cases.
我们回顾性研究了40例因钝挫伤而接受巩膜破裂探查的患眼。其中29例存在巩膜破裂。在这29例中，10例术前可见破裂，19例为隐匿性破裂。术前提示巩膜破裂的表现为光感或无光感视力、眼压低于10 mmHg、前房积血和球结膜水肿。29例破裂中，27例累及上半球，25例累及眼球前半球。29例巩膜破裂患眼中有10例（34%）、11例未破裂患眼中有8例（73%）在平均6.7个月的随访期后最终视力达到5/200或更好。眼球破裂和未破裂患眼能获得可走动视力的预后因素包括初始视力为5/200或更好、无巩膜破裂以及破裂眼球的破裂长度小于11 mm。接受玻璃体切割术的患眼结果也更好，提示早期经平坦部玻璃体切除术对部分破裂病例有益。
