外伤性睫状体解离19例的诊断和治疗

目的：探讨外伤性睫状体解离及其并发症的临床治疗效果。方法：我院1993—01／2003—06共收治钝挫伤所致的外伤性睫状体解离19例(19眼)，男12例，女7例，年龄6～44(平均25)岁。就诊时眼压为0～10(平均2．42)mmHg。14例行睫状体显微缝合固定术，其中3例联合巩膜环扎局部冷凝；4例行改良的睫状体缝合固定术-平行于角巩膜缘、不切透深层巩膜，并重叠缝合。3例行保守治疗，2例行氩激光光凝。结果：在14例行睫状体显微缝合固定术病例中，一次手术成功9例(64．3％)；二次手术成功3例(21．4％)；三次手术成功2例(14．3％)。术后随访时间1月～8a，平均眼压11．24mmHg，较术前有明显提高(Wilcoxon—Mann—Whitney，P=0．0052)。最后随访视力较术前有明显提高(Wilcoxon signrank，P=0．012)。结论：睫状体缝合固定术是有效的治疗外伤性睫状体解离的手段：改良的手术方法可进一步提高成功率：超声生物显微镜可准确诊断外伤性睫状体解离，对手术成功有重要帮助。

Diagnosis and treatment of 19 patients with traumatic cyclodialysis

AIM: To evaluate the diagnosis and treatment of traumatic cyclodialysis and its complications.METHODS: Nineteen consecutive patients (19 eyes),12 men and 7 women, with the diagnosis of traumatic cyclodialysis following ocular injuries were admitted from January 1993 to June 2003. The patients ranged from 6to 44 years (mean 25 years) in age. Presenting intraocular pressure ranged from 0 to 10 mmHg. Surgical cyclopexy was performed on 14 patients, of whom, 3 underwent combined scleral buckling and cryotherapy and 4underwent an improved ciliary fixation surgery. Three patients underwent conservative management, and 2 underwent Argon laser photocoagulation.RESULTS: Of the 14 patients underwent surgical cyclopexy, cyclodialysis cleft was successfully closed with 1operation in 9 patients, with 2 operations in 3 patients,with 3 operations in 2 patients. Postoperative follow-up ranged from 1 month to 8 years. Postoperatively, intraocular pressure was 6 to 20mmHg (mean 11.24mmHg), and visual acuity was significantly improved.CONCLUSION: Surgical cyclopexy is a successful treatment for traumatic cyclodialysis; improved surgical procedure may further increase success rate; ultrasound biomi-croscopy can accurately diagnose the presence of traumatic cyclodialyses and can aid in surgical management.