Stegmann R, Miller D
Ann Ophthalmol. 1986 Jan;18(1):9-13.
This study describes the surgical treatment and eventual outcome of 15 cases of anterior-segment penetrating ocular trauma that would be classically considered as having a poor prognosis. Signs of poor prognosis included: corneal lacerations, complicated by signs of infection ranging from infiltration to necrotic digestion; large scleral lacerations, with ciliary body or choroidal prolapse; and an exaggerated inflammatory response to the trauma. Treatment included careful microsurgical techniques, vitrectomy (when necessary), use of antibiotics and anti-inflammatory agents, and the liberal use of sodium hyaluronate to break fibrin adhesions and maintain the chamber at the close of surgery. Such treatment resulted in no enucleations, an average best corrected visual acuity of 20/80, an average normal angle of 314 degrees, and 13 cases of normal intraocular pressure without medication.
本研究描述了15例前段穿透性眼外伤的手术治疗及最终结果，这些病例传统上被认为预后较差。预后不良的体征包括：角膜裂伤，并伴有从浸润到坏死溶解的感染体征；大的巩膜裂伤，伴有睫状体或脉络膜脱垂；以及对创伤的过度炎症反应。治疗包括精细的显微外科技术、玻璃体切除术（必要时）、使用抗生素和抗炎药，以及在手术结束时大量使用透明质酸钠以分解纤维蛋白粘连并维持前房。这样的治疗没有导致眼球摘除，平均最佳矫正视力为20/80，平均正常房角为314度，13例患者无需药物治疗眼压正常。
