伴球内异物的开放性眼外伤早期行玻璃体手术的疗效观察

摘要

目的 评估伴有球内异物的开放性眼外伤在伤后48 h内行玻璃体手术的疗效.方法 回顾性分析我院2009年1月1日至2015年3月1日收治的56例(56眼)开放性眼外伤(OGIs)患者的临床资料;所有患者均伴有球内异物(IOFB),且在受伤48 h内行经睫状体扁平部的玻璃体切割术(PPV).结果 在56眼中,IOFB发生眼内炎的有16眼,不伴有眼内炎的有40眼;术后异物取出率100％.52例患者术后眼球得以保存,4眼眼球保存失败.在24-48 h行PPV的球内异物伴眼内炎患者的比率是24 h内手术的2.09倍.24 h内行PPV的患者眼球保存、一次性视网膜复位、眼压异常情况与24～48 h手术者比较差异无统计学意义.结论 早期玻璃体切割手术是治疗伴有球内异物的开放性眼外伤安全、有效的手段.%Objective To evaluate the clinical effect of vitrectomy for open globe injuries with intraocular foreign bodies in 48 hours after injury.Methods Retrospective analysis was used to evaluate the patients with open globe injuries (OGIs) accompanied by intraocular foreign bodies (IOFB) who underwent vitrectomy of pars plana vitrectomy (PPV) within 48 hours during the period from January 1,2009 to March 1,2015 in our hospital.Results Among the 56 eyes,16 eyes with intraocular foreign bodies occurred endophthalmitis,while the other 40 eyes did not;the intraocular foreign bodies removal rate was 100％.Among all the patient eyes,52 eyes were saved after surgery,while 4 eyes failed.The pars plana vitrectomy operation ratio of the intraocular foreign bodies patients with endophthalmitis and operated within 24 to 48 hours was 2.09 times than that within 24 hours.There was no significant difference in terms of eye preservation,one time of retinal reposition and abnormal intraocular pressure no matter the PPV surgery was conducted within 24 hours or 24 to 48 hours after injury.Conclusion Early vitrectomy is a safe and effective method for the treatment of open globe injuries with intraocular foreign bodies.