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目的 探讨 36 0°视网膜切除在救治重症眼球破裂伤中的应用价值 ,评估影响预后的相关因素。 方法 对我院 1999年 1月～ 2 0 0 2年 10月收治的重症眼球破裂伤 2 8例 ,2 8只眼进行回顾性分析 ,其中男 18例 ,女 10例 ,年龄 16～ 5 8岁 ,平均年龄 2 9岁。根据机械性眼外伤国际分类 ,伤口位于 区 5例 ,5只眼 , ～ 区 8例 ,8只眼 , 区 3例 ,3只眼 , ～ 区 5例 ,5只眼 , 区 7例 ,7只眼。伤后视力分级 : 级 (0 .0 2～光感 ) 19例 , 级 (无光感 ) 9例。 2 8例中 13例术前虹膜及晶状体全部缺失 ,10只眼虹膜缺失大于 1/2 ,晶状体混浊或破碎 15只眼。超声生物显微镜 (ultrasound bomicroscopy UBM)及 B型超声提示睫状体脉络膜脱离 17只眼 ;全部病例 B型超声均提示玻璃体积血及视网膜脱离 ,眼压在 5～ 11mm Hg(1m m Hg=0 .133k Pa)之间。手术均为同一位手术者操作 ,采用常规巩膜三通道闭合式玻璃体切除 ,巩膜外环扎 ,合并晶状体切除 15例 ,赤道前 36 0°视网膜切开及切除 16只眼 ,赤道后切开及切除 12只眼 ,全部病例手术中均行眼内激光光凝 ,硅油填充。 结果 手术中证实全部病例均有严重的玻璃体积血及视网膜脱离 ,其中合并出血性睫状体脱离 9只眼 ,合并脉络膜上腔积血 12只眼 ,视网膜呈喇叭花茎样扭曲 11只?
Objective To investigate the value of 36 ° retinal resection in the treatment of severe ocular rupture and evaluate the related factors that affect prognosis. Methods A retrospective analysis was performed on 28 cases and 28 eyes of severe ocular rupture admitted from January 1999 to October 2002 in our hospital, including 18 males and 10 females, aged from 16 to 58 years , The average age of 29 years old. According to the international classification of mechanical ocular trauma, the wounds were located in 5 cases, 5 eyes, 8 cases in ~ area, 8 eyes, 3 cases in 3 cases, 3 eyes in 5 cases, 5 eyes in 5 cases, 7 cases in 7 cases eye. Post-injury visual acuity grading: grade (0. 02 ~ light sense) in 19 cases, grade (no light perception) in 9 cases. Of the 28 cases, 13 cases had preoperative iris and lens loss, 10 eyes had iris loss greater than 1/2, and ophthalmopathy was cloudy or broken 15 eyes. Ultrasound biomicroscopy (UBM) and B ultrasound showed ciliary choroidal detachment in 17 eyes. In all cases, B type ultrasound showed vitreous hemorrhage and retinal detachment. The intraocular pressure was in the range of 5-11 mm Hg (1 m Hg). 133k Pa). All the operations were performed by the same surgeon. Conventional sclera three-channel closed vitrectomy, scleral external cerclage, combined lens removal in 15 cases, equatorial 36 ° retinal incision and resection in 16 eyes were performed. The posterior equatorial resection and resection 12 eyes, all cases underwent intraocular laser photocoagulation surgery, silicone oil filled. Results All the cases were proved to have severe vitreous hemorrhage and retinal detachment during surgery. Among them, 9 cases were complicated with hemorrhagic ciliary body detachment, 12 eyes were complicated with choroidal hemorrhage, 11 were dorsal-horn-like retinas.