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全氟化碳液体作为治疗严重开放性眼球损伤的短期填塞物。

Perfluorocarbon liquid as a short-term tamponade for managing severe open globe injuries.

作者信息

Li Liang, Sun Xinghong, Su Mengru, Wang Xiaofang, Jiang Feng

机构信息

Department of Ophthalmology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, No.321 Zhongshan Rd, Nanjing, 210008, Jiangsu, China.

出版信息

Int J Retina Vitreous. 2025 Mar 25;11(1):35. doi: 10.1186/s40942-025-00659-4.

Abstract

PURPOSE

To explore the use of perfluorocarbon liquids (PFCLs) as a short-term tamponade in a staged vitrectomy approach for managing severe open globe injuries (OGIs).

METHODS

This retrospective, interventional case series included patients undergoing 23-gauge pars plana vitrectomy with PFCL tamponade for 7-14 days (mean 11.2 ± 3.36 days), followed by secondary vitrectomy and silicone oil exchange. Key outcome measures included retinal and choroidal reattachment rates, best-corrected visual acuity (BCVA), intraocular pressure (IOP), and postoperative complications. Statistical analyses were performed using McNemar's test and Student's t-test.

RESULTS

Five eyes from five patients (mean age 55.6 ± 10.12 years; male to female ratio 4:1) were included, with a mean follow-up of 8.4 ± 4.9 months. All patients sustained zone II and III globe ruptures secondary to blunt trauma, with baseline visual acuity ranging from light perception (LP) to no light perception (NLP). Intraoperative findings included total hyphema, funnel retinal detachment, traumatic choroidal rupture (TCR), suprachoroidal hemorrhage (SCH) and extensive intraocular hemorrhage (EIH). Following PFCL removal, SCH exhibited full or partial resolution, and the posterior retina remained attached in all cases. All eyes were salvaged, and visual acuity improved to hand motion (HM) on postoperative day 1, maintaining stability throughout follow-up (P = 0.03682). No significant IOP changes were observed postoperatively (preoperative: 9.66 ± 2.38 mmHg; postoperative: 9.48 ± 3.31 mmHg, P = 0.9063). Retinal and choroidal attachment were maintained during follow-up, with no cases of phthisis bulbi, endophthalmitis, recurrent hyphema, or ocular hypertension. One patient developed corneal degeneration three months postoperatively.

CONCLUSIONS

Short-term PFCL tamponade in a staged vitrectomy may facilitates retinal and choroidal stabilization while minimizing complications, offering a viable alternative for managing severe OGIs.

摘要

目的

探讨在分期玻璃体切除术中使用全氟碳液体(PFCL)作为短期填塞物来处理严重开放性眼球损伤(OGI)。

方法

本回顾性、介入性病例系列研究纳入了接受23G经平坦部玻璃体切除术并使用PFCL填塞7 - 14天(平均11.2±3.36天),随后进行二期玻璃体切除术和硅油置换的患者。主要观察指标包括视网膜和脉络膜复位率、最佳矫正视力(BCVA)、眼压(IOP)及术后并发症。采用McNemar检验和学生t检验进行统计学分析。

结果

纳入了5例患者的5只眼(平均年龄55.6±10.12岁;男女比例为4:1),平均随访8.4±4.9个月。所有患者均因钝挫伤导致Ⅱ区和Ⅲ区眼球破裂,基线视力从光感(LP)到无光感(NLP)不等。术中发现包括全前房积血、漏斗状视网膜脱离、外伤性脉络膜破裂(TCR)、脉络膜上腔出血(SCH)和广泛的眼内出血(EIH)。去除PFCL后,SCH完全或部分消退,所有病例的后部视网膜均保持附着。所有眼球均得以挽救,术后第1天视力提高到手动(HM),并在整个随访期间保持稳定(P = 0.03682)。术后未观察到显著的眼压变化(术前:9.66±2.38 mmHg;术后:9.48±3.31 mmHg,P = 0.9063)。随访期间视网膜和脉络膜保持附着,未发生眼球痨、眼内炎、复发性前房积血或高眼压病例。1例患者术后3个月发生角膜变性。

结论

分期玻璃体切除术中短期使用PFCL填塞可促进视网膜和脉络膜稳定,同时将并发症降至最低,为处理严重OGI提供了一种可行的替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86bd/11934580/babd505998f1/40942_2025_659_Fig1_HTML.jpg

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