目的 探讨虹膜裂伤的整形技巧,并观察瞳孔成形术手术前后视力的变化.方法 前瞻性自身对照研究.收集2009年5月至2010年7月就诊的各种虹膜损伤15例(15眼),对患者实施瞳孔成形术,其中裂伤修补8例,离断修补4例,角膜荷包缝合3例.观察患者手术前后视力、瞳孔和畏光感的变化.采用配对t检验.结果 患者术前瞳孔直径为(5.33±1.93)mm,术后缩小为(3.15±0.54)mm,差异有统计学意义(t=4.31,P＜0.01)；术前矫正视力为4.70±0.23,术后提高到4.82±0.21,差异有统计学意义(t=4.38,P＜0.01)；术后畏光感明显减轻(t=3.90,P＜0.05).结论 瞳孔成形术可以明显减轻患者的畏光感,提高视力；经角膜荷包缝合是矫正外伤性瞳孔强直的一种有效方法.%Objective To discuss the surgical skills for iris repair and to observe the effect of coreoplasty on postoperative visual acuity.Methods It was a prospective self-controlled study.From May 2009 to July 2010, 15 eyes of 15 patients with ocular trauma were studied and treated with coreoplasty,including 3 with purse string suture through the cornea,8 with iris laceration repair and 4 with iridodialysis repair.Purse string suture to treat traumatic mydriasis through the cornea is a novel approach.Uncorrected and best corrected visual acuity were examined in all patients preoperatively and postoperatively.Images of the pupils were taken and the diameters of the pupils were calculated.Data were analyzed using paired samples t test.Results The diameters of the pupils were 5.33±1.93 mm before surgery, and reconstructed to 3.15±0.54 mm after surgery, which represents a significant difference due to the surgery (t-4.31,P＜0.01).Postoperative acuities were 4.82±0.21,which differed from preoperative vision of 4.70±0.23 (t=4.38, P＜0.01).Furthermore, photophobia decreased after surgery (t=3.90,P＜0.05).Conclusion Iris coreoplasty can reduce photophobia and improve visual acuity for iris trauma patients.Purse string suture is a feasible and efficacious technique for treating traumatic mydriasis.
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