Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany.
Ophthalmology Clinic and Polyclinic, Technical University of Munich, Munich, Germany.
Eur J Ophthalmol. 2021 Nov;31(6):3300-3308. doi: 10.1177/1120672121991052. Epub 2021 Jan 28.
Patients who have suffered an ocular trauma may present with varying degrees of injury to the anterior segment. In this retrospective interventional case series, we report the outcome of seven patients who underwent complete anterior segment reconstruction in a single surgery.
All patients with posttraumatic corneal decompensation or scar, aphakia, and iris defect underwent human donor corneal graft transplantation and implantation of an intraocular lens combined with a flexible silicone iris prosthesis. Postoperative examinations included assessment of best corrected distance visual acuity, objective refraction, and intraocular pressure. Sensitivity to glare and subjective discontent with the eye's appearance was rated on a scale from 1 to 10, with 1 standing for low and 10 for high severity.
Mean best corrected distance visual acuity (BCDVA) was 1.51 ± 0.26 logMAR preoperatively and 1.29 ± 0.36 logMAR postoperatively. Mean IOP was 15.71 ± 8.94 mmHg pre-surgery and 13.57 ± 6.52 mmHg post-surgery. The mean sensitivity to glare was reduced from 7.17 ± 2.91 to 3.80 ± 3.43 and subjective cosmetic disfigurement was reduced from 5.33 ± 3.35 to 1.80 ± 1.60.
A single surgery technique for entire anterior segment reconstruction in trauma patients can effectively reduce glare and patient discontent with the eye's appearance.
眼外伤患者可能会出现前节不同程度的损伤。在这项回顾性的介入性病例系列研究中，我们报告了 7 例患者在一次手术中进行完全前节重建的结果。
所有因创伤性角膜失代偿或瘢痕、无晶状体和虹膜缺损的患者均行同种异体角膜移植和人工晶状体植入，并联合使用可折叠硅胶虹膜假体。术后检查包括最佳矫正远视力、客观屈光和眼压的评估。采用 1 到 10 分的量表评估对眩光的敏感性和对眼睛外观的主观不满，1 分表示低度，10 分表示高度。
平均最佳矫正远视力（BCDVA）术前为 1.51±0.26 logMAR，术后为 1.29±0.36 logMAR。术前平均眼压为 15.71±8.94mmHg，术后为 13.57±6.52mmHg。平均眩光敏感度从 7.17±2.91 降低到 3.80±3.43，主观美容缺陷从 5.33±3.35 降低到 1.80±1.60。
一种用于创伤患者整个前节重建的单一手术技术可以有效地减少眩光和患者对眼睛外观的不满。
