隱匿性鞏膜破裂傷的臨床分析

目的探討隠匿性鞏膜破裂傷的臨床診斷要點及手術方法.方法同顧分析了21例隱匿性鞏膜破裂傷的臨床資料.結果視力術後随訪半年～2年,視力0.1～04者3眼,0.02～0.1者7眼,眼前手動5眼,光感2眼,無光感4眼.1眼脱殘,20眼眼球保持了正常外形,1眼行二期眼球摘除外.結論視力光感以下、球結膜水腫、結膜下大量出血、眼壓低及前房積血爲隱匿性鞏膜破裂傷的診斷依據.眼球蓮動某一方向受限、眼球塌陷變形及角膜横形皺紋對診斷有重要的参考價值.對疑有鞏膜破裂的患者早期行手術探查是避免漏診和誤診的關鍵,視力無光感已不再作爲眼球摘除的唯一指徵,適時行玻璃體手術可以獲得較好效果.

Clinical analysis of latent rupture in sclera

Objective To discuss the clinical diagnosis main points and operative methods. Method Review and analyze 21 clinical data on latent rupture on solera. Result By following-up for half to 2 years after operation, We got data as follows: visual acuity 0.1~0.4 three eyes,o.o2~o. 1 seven eyes, being able to see moving hand five eyes, light perception two eyes, no light perception four eyes, recovery from disability one eye, regain normal external appearance twenty eyes, besides, second stage of enucleation one eye. Conclusion conditions worse than light perception, conjunctival edema, subconjunctival hemorrhage, ocular hypotention and hyphema are grounds for diagnosis of rupture in sclera. The limit of eyeball movement to certain direction, a caved in and deformed eyeball and lateropulsive wrinkle in cerato do great contribution to the diagnosis. The key to avoid missing diagnosis or misdiagnosis is to perform surgical exploration. No light perception is no longer the sole reason to perform enucleation of eyeball. It would get better result if the vitreous operation is performed in time.