眼球钝挫伤致玻璃体积血时手术时机选择的研究

目的:探讨眼球钝挫伤致玻璃体积血手术治疗的时机,并对治疗效果进行评价。方法:对我院2010-01/2011-12收治的眼球钝挫伤玻璃体积血患者56例56眼进行回顾性分析,根据玻璃体积血时间分组:Ⅰ组15~30d,14眼;Ⅱ组31~60d,22眼;Ⅲ组>60d,20眼。手术采用经睫状体平坦部玻璃体切割术,术后随访时间6~24mo,数据结果采用SPSS 10.0进行统计学分析。结果:患者术后最终视力:Ⅰ组平均视力0.37±0.223,Ⅱ组0.18±0.216,Ⅲ组0.12±0.128,Ⅰ组和Ⅱ组视力比较,有显著统计学差异（χ²=13.383,P<0.01）；Ⅰ组和Ⅲ组视力比较,有显著统计学差异（χ²=13.217,P<0.01）；Ⅱ组和Ⅲ组视力比较,无显著统计学差异（χ²=0.045,P>0.05）。结果表明15~30d内行手术治疗最终视力明显高于>30d手术组患者,最终视力随术前玻璃体积血时间的延长呈下降趋势。结论:患者最终视力随术前玻璃体积血时间的延长呈下降趋势, 15~30d内手术治疗可取得比较好的视力效果。

Clinical research of operation time for vitreous hemorrhage resulted from ocular contusion

AIM:To investigate the best time of surgery for vitreous hemorrhage resulted from ocular contusion and to evaluate the therapeutic effect.METHODS:Retrospectively analyze the 56 cases(56 eyes) of vitreous hemorrhage resulted from ocular contusion which registered in our hospital from January 2010 to December 2011. According to vitreous hemorrhage time, all the cases were divided into three groups:14 eyes of groupⅠfor 15-30 days, 22 eyes of group Ⅱ for 31-60days and 20 eyes of group Ⅲ for over 60 days. The operation used pars plana vitrectomy, and the postoperative follow-up was 6-24 mouths. The data was analyzed by SPSS 10.0.RESULTS:The final visual acuity of all cases is respectively 0.37±0.223 for the groupⅠ, 0.18±0.216 for the group Ⅱ and 0.12±0.128 for the group Ⅲ. Visual acuity of groupⅠcompared with group Ⅱ,there was statistical significant difference(χ2=13.383,P<0.01).Visual acuity of groupⅠcompared with group Ⅲ, there was statistical significant difference (χ2=13.217, P<0.01). Visual acuity of groupⅡcompared with group Ⅲ, there was statistical significant difference (χ2=0.045,P>0.05). All result suggested that the final visual acuity of performing surgery within 15-30 days was better than that after 30 days, and the final visual acuity decreased with the time of vitreous hemorrhage.CONCLUSION:The final visual acuity decreased with the prolonged time of vitreous hemorrhage. Within 15-30 days, the final visual acuity can gain good outcome by surgery.