眼挫伤致晶状体后脱位的晶状体玻璃体切除术

目的探讨玻璃体切除联合晶状体切除术治疗眼挫伤致晶状体后脱位的临床疗效。方法对22眼外伤程度、手术方式及效果等资料进行回顾性分析。结果除晶状体后脱位以外，合并损伤主要包括不同程度前房角后退10眼，视网膜震荡伤8眼，玻璃体疝6眼，前房或玻璃体积血5眼，外伤性瞳孔散大4眼，虹膜根部断离3眼，视网膜脱离3眼，视网膜裂孔2眼，视网膜脉络膜裂伤1眼。22眼均施行玻璃体切除联合晶状体切除术，术中同时眼内激光封孔和C，F。气液交换5眼，小梁切除3眼，硅油注入1眼，虹膜根部断离修补1眼，一期植入前房型人工晶状体3眼。术前矫正视力≤0．15。术后随访1～27月，矫正视力≥0．2者13眼。结论术前充分评估眼外伤程度，有利于合理选择手术时机和手术方式；玻璃体切除联合晶状体切除术能有效摘出脱位晶状体，可同时进行裂孔封闭、视网膜复位、小梁切除、虹膜断离根部修补、人工晶状体植入等操作，最大程度修复创伤。

Lentectomy combined vitrectomy for posterior luxation of lens caused by blunt ocular trauma.

Objective To evaluate the effect of lentectomy combined vitrectomy for posterior luxafion of lens caused by blunt ocular trauma. Methods The clinical data of 22 cases about traumatic level, operation mode. visual acuity was reviewed retrospectively. Results Except luxation of lens, several serious injuries were existed at the same time, include anterior chamber angle injury lOeyes, commotio retinae 8eyes. vitreous hernia 6eyes. bleeding in anterior chamber or vitreous 5eyes. traumntic pupil dilate 4eyes. the root of iris dividing 3eyes. retina detachment 3eyes. retina hole 2eyes. retina and choroid laceration leye. Lentectomy , combined vitrectomy was performed for 22 eyes, at the same time laser and C3F8 were used in 5 eyes, silicon oil was used in leye, trabeculectomy was done in 3eyes, reposition of iris root was done in 1 eye, intra-ocular lens were first implanted in 3 eyes. The visual acuity of 22 eyes is less than or equal to 0. 15 before the operation. Followed up for 1 -27 months, thecorrected visual acuity of 13 eyes was above orequal to O. 2. Conclusions （ 1 ） It is useful to select rational operation time and method if we evaluated the injury degree of the eye ball carefully before the operation. （2） Lentectomy combined vitreetomy was effective to treat posterior luxation of lens. Retina reposition, seal retina hole, trabeculectomy, iris neoplasty or intra-ocular lens implant could be done at the same time to maximum repair the injury eye.