外伤性眼球全积和次全积的初次玻璃体切除术

S. N. Subbotina, S. S. Shamkin, A. Stepanyants
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引用次数: 0

摘要

目的:介绍初次早期玻璃体切除术在伴有穿透性伤口和严重眼部挫伤的眼球次全和全积血患者中的功能结果。材料和方法。观察了41例患者,包括24例(24眼)穿透性眼损伤和17例(17眼)严重眼挫伤。所有患者均有次全或全眼球积血。所有患者在受伤后3天内接受25G三孔玻璃体切除术。33名患者接受了含硅油5700的填塞物,8名患者接受气体-空气混合物C3F8。随访6个月。后果术后第一天,31名接受硅油填塞治疗的患者视力有所改善。在气体空气填塞的情况下,1天内获得了作为光感的视力;随着气体的吸收,8例均出现客观视觉。手术六个月后,取得了良好的解剖结果:在任何一位患者中都没有发现亚营养不良的迹象。4例(9.75%)观察到不良结果(缺乏或不正确的光感),相对良好的功能结果为客观视力小于0.1,17例(41.5%),20例(49%)观察到视力大于0.15的良好结果。8名患者(19.5%)出现增殖性玻璃体视网膜病变迹象,与现有文献统计数据相比,在严重穿透性伤口和挫伤以及许多复杂因素的情况下,这是一个良好的结果。结论我们的研究表明,对于伴有穿透性眼外伤和严重挫伤的全眼球和次大出血患者,应在早期进行初次玻璃体切除术。手术后,患者的视力在统计学上显著提高,具有稳定的解剖结果,并且从长远来看,获得良好的功能结果。
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Primary vitrectomy in total and subtotal hemophthalmos of traumatic etiology
Purpose: to present the functional results of primary early vitrectomy in patients with subtotal and total hemophthalmos with penetrating wounds and severe contusions of the eye. Material and methods. 41 patients were observed, including 24 patients (24 eyes) with a penetrating eye injury and 17 patients (17 eyes) with a severe eye contusion. All patients had subtotal or total hemophthalmos. All patients underwent a 25G three-port vitrectomy no later than 3 days after the injury. 33 patients received a tamponade with silicone oil 5700, and 8 patients received gas-air mixture C3F8. The follow-up period was 6 months. Results. On the first day after surgery, 31 patients treated with silicone oil tamponade showed an improvement in visual acuity. With gas-air tamponade, visual acuity as light perception was obtained for 1 day; as the gas resorbed, objective vision appeared in all 8 cases. Six months after the surgery, a good anatomical result was achieved: no signs of subatrophy were detected in any of the presented patients. An unfavorable outcome (lacking or incorrect light perception) was observed in 4 cases (9.75%), a relatively favorable functional outcome in the form of objective vision less than 0.1, in 17 cases (41.5%), a favorable outcome with visual acuity above 0.15 in 20 cases (49%). Signs of proliferative vitreoretinopathy were noted in 8 patients (19.5%), which in cases of severe penetrating wounds and contusions and a number of complicating factors is a good result as compared to the available literature statistics. Conclusion. Our study shows that in patients with total and subtotal hemophthalmos with penetrating eye wounds and severe contusions, primary vitrectomy should be performed at an early stage. After the surgery the patients receive a statistically significant increase in visual acuity, have a stable anatomical result and, in the long term, obtain a good functional result.
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CiteScore
0.50
自引率
0.00%
发文量
107
审稿时长
16 weeks
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