严重眼球破裂伤玻璃体视网膜手术挽救视力的价值

目的探讨严重眼球破裂伤玻璃体视网膜手术临床效果。方法12例（12眼）严重巩膜破裂，均为钝挫伤。有脉络膜下腔出血、脉络膜裂伤、脉络膜脱离及视网膜脱离等。进行巩膜伤口一期缝合，脱出的眼内容物尽可能还纳，眼内注入透明质酸钠恢复眼压及眼球形态。7～10d行常规睫状体平坦部三通道闭合式玻璃体视网膜手术。结果8例眼压高于10mmHg，视力光感-0．03。1例术后2周眼球萎缩行义眼台植入术；3例眼压5～10mmHg有不同程度的眼球萎缩但视力为光感；3年后1例角膜失代偿，因大泡性角膜病变行眼球摘除义眼台植入术。结论严格选择手术适应症及手术时机，掌握熟练的手术技巧，则玻璃体视网膜手术能够挽救大多数严重眼球破裂伤的视力。

The clinical value of vitreoretinal surgery to save visual function in serious eyeball rupture

Objective To study clinical curative effect of vitreoretinal surgery for serious rupture of eyeball.Methods All the 12 cases( 12 eyes) of serious eyeballs rupture were ocular blunt trauma,with scleral mpture,choroidal hemorrhage,choroidal rupture,choroidal detachment and retinal detachment,etc.Primary to suture the wounds of sclera,return the prolapsed ocular contents as much as possible,and inject sodium hyaluronate into the eyeballs for recovering intraocular pressure figure of eyeball.To perform standard triple incision vitreoretinal surgery through pars plans after 7 - 10 days.Results The visual acuity were light perception to 0.03,and IOP ＞ 10 mmHg in 8 cases.The hydroxyapatite orbital implant surgery was performed for eyeball atrophy in one case.Different degrees of eyeball atrophy in 3 cases with light perception in vision.Eyeball enucleating and orbit implant in 1 case for dysfunctional corneal endothelium and bullous keratopathy 3 years later.Conclusion Vitreoretinal surgry,with strict selected indications,proper surgical timining and qualified surgical operation,could save most of serious eyeball rupture eyes.