Tolentino F I, Liu H S, Freeman H M, Natchiar G
Ann Ophthalmol. 1979 Nov;11(11):1763-71.
To study the value and the proper timing of vitrectomy in cases of ocular trauma involving the posterior segment, 24 rabbit eyes were traumatized by introducing a steel foreign body and autogenous blood into the vitreous. Twelve eyes underwent vitrectomy, 6 in the first week after trauma ("early") and 6 in the fourth week ("late"). The other 12 eyes, which underwent removal of the foreign body but not vitrectomy, served as controls. Traction retinal detachment did not develop in the 6 early-vitrectomy eyes, but it did occur before vitrectomy in 4 of the 6 eyes of the late-vitrectomy group and in 6 of the 12 control eyes. Iatrogenic cataract and retinal breaks were twice as frequent in the late as in the early group. The data seem to favor early vitrectomy in eyes with posterior-segment trauma. However, in routine clinical practice we advise prompt primary repair and exploration to evaluate the extent of posterior-segment damage, and vitrectomy within 14 days after injury.
为研究玻璃体切割术在涉及眼后段的眼外伤病例中的价值及合适时机,通过向玻璃体腔内注入钢质异物和自体血对24只兔眼造成创伤。12只眼接受了玻璃体切割术,其中6只在创伤后第一周(“早期”)进行,6只在第四周(“晚期”)进行。另外12只眼仅取出异物而未行玻璃体切割术,作为对照。早期玻璃体切割术的6只眼中未发生牵引性视网膜脱离,但晚期玻璃体切割术组的6只眼中有4只在玻璃体切割术前发生了牵引性视网膜脱离,12只对照组眼中有6只发生了牵引性视网膜脱离。晚期组医源性白内障和视网膜裂孔的发生率是早期组的两倍。数据似乎支持对眼后段外伤的眼睛尽早进行玻璃体切割术。然而,在常规临床实践中,我们建议进行及时的一期修复和探查,以评估眼后段损伤的程度,并在受伤后14天内进行玻璃体切割术。