Haut J, Allagui M, Lepvrier N, Morel C
Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris.
J Fr Ophtalmol. 1993;16(12):668-72.
We performed surgical scleral buckling with an encircling band to prevent retinal detachment in twenty eyes with severe ocular injury (three contusions, seventeen penetrating eye injuries including twelve eyes with intraocular foreign bodies). All surgical buckling were performed during the two weeks following the injury. The purpose of this surgical procedure is to prevent the traction from contracting vitreous base which it itself secondary to vitreoretinal proliferation; several factors promote this latter outcome: perforating injury, vitreous hemorrhage, intraocular foreign body and the mix of vitreous substance and lens material. This prophylaxis is justified by the high frequency and often bad prognosis of post-traumatic retinal detachment. A mean follow-up of thirteen months showed no contusion associated delayed retinal detachment, with a final visual acuity superior to 7/10: thus, preventive surgical buckling appears efficient; perforating injuries were followed by retinal detachment in three cases; of these, two were reattached, and the final visual acuity depended on associated destructions. With the limitation of a short follow-up, this surgical procedure seems to be able to prevent most of the delayed retinal detachments.
我们对20只严重眼外伤（3只挫伤，17只穿透性眼外伤，其中12只眼有眼内异物）的眼睛进行了巩膜扣带术，使用环扎带以预防视网膜脱离。所有手术扣带均在受伤后的两周内进行。该手术的目的是防止继发于玻璃体视网膜增殖的玻璃体基底部收缩所产生的牵引；有几个因素会促使后者发生：穿通伤、玻璃体积血、眼内异物以及玻璃体物质与晶状体物质的混合。这种预防性措施是合理的，因为创伤后视网膜脱离的发生率高且预后往往不佳。平均随访13个月显示，没有与挫伤相关的延迟性视网膜脱离，最终视力优于7/10：因此，预防性手术扣带似乎是有效的；3例穿通伤后发生了视网膜脱离；其中2例视网膜复位，最终视力取决于相关的破坏情况。由于随访时间较短，这种手术方法似乎能够预防大多数延迟性视网膜脱离。
