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钝挫伤致眼球破裂后行大范围脉络膜视网膜切除术的长期功能和结构转归

Long-term functional and structural outcomes after large chorioretinectomy for ruptured globe following blunt trauma.

作者信息

Mura Marco, Iannetta Danilo, Pellegrini Marco, Engelbrecht Leonore A, Sarti Laura, Parmeggiani Francesco, Badawi Abdulrahman, Dhibi Hassan, Al Sulaiman Sulaiman

机构信息

Department of Translational Medicine, University of Ferrara, Ferrara, Italy.

Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia.

出版信息

Int J Retina Vitreous. 2023 Aug 31;9(1):52. doi: 10.1186/s40942-023-00492-7.

Abstract

BACKGROUND

The purpose of this study was to present a modified surgical technique involving pars plana vitrectomy with large chorioretinectomy for eyes with rupture of the globe due to severe ocular blunt trauma.

METHODS

This retrospective study included consecutive patients with rupture of the globe due to blunt trauma who were treated at the King Khaled Eye Specialist Hospital (Riyadh, Saudi Arabia). All patients underwent 25-gauge pars plana vitrectomy with large chorioretinectomies involving all the tissue around the posterior scleral wounds. Outcome measures included best-corrected visual acuity (BCVA), anatomical success and globe survival, rates of complications.

RESULTS

15 eyes of 15 patients were included. Mean BCVA was 2.88 ± 0.13 logMAR at presentation, and significantly improved to 0.83 ± 0.28 logMAR (P < 0.001), with 10 patients (67%) achieving a final BCVA ≥ 20/200. Anatomical success and globe survival were achieved in 11 (73%) and 15 (100%) of eyes, respectively. Postoperative complications included retinal detachment in 6 eyes (40%), epiretinal membrane in 6 (40%), hypotony in 4 (26%), PVR in 2 (13%).

CONCLUSIONS

Pars plana vitrectomy with large chorioretinectomy is an effective treatment for globe rupture following severe blunt trauma, yielding good visual outcomes and anatomical success rates.

摘要

背景

本研究的目的是介绍一种改良的手术技术,即对因严重眼钝挫伤导致眼球破裂的眼睛进行玻璃体切除联合大范围脉络膜视网膜切除术。

方法

这项回顾性研究纳入了在沙特阿拉伯利雅得国王哈立德眼科专科医院接受治疗的因钝挫伤导致眼球破裂的连续患者。所有患者均接受了25G玻璃体切除联合大范围脉络膜视网膜切除术,切除包括后巩膜伤口周围所有组织。观察指标包括最佳矫正视力(BCVA)、解剖学成功和眼球存活情况、并发症发生率。

结果

纳入15例患者的15只眼。初诊时平均BCVA为2.88±0.13 logMAR,显著改善至0.83±0.28 logMAR(P<0.001),10例患者(67%)最终BCVA≥20/200。分别有11只眼(73%)实现了解剖学成功,15只眼(100%)实现了眼球存活。术后并发症包括视网膜脱离6只眼(40%)、视网膜前膜6只眼(40%)、低眼压4只眼(26%)、增殖性玻璃体视网膜病变2只眼(13%)。

结论

玻璃体切除联合大范围脉络膜视网膜切除术是治疗严重钝挫伤后眼球破裂的有效方法,可取得良好的视力和解剖学成功率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f408/10472549/7acacd2e8de1/40942_2023_492_Fig1_HTML.jpg

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