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目的 观察玻璃体视网膜手术治疗严重眼球钝挫伤的疗效 ,分析手术失败原因。方法 57例 57眼严重眼球钝挫伤行玻璃体视网膜手术治疗 ,回顾性分析受伤至手术时间与手术疗效的关系 ,以及手术并发症的处理。结果 玻璃体视网膜手术治疗严重眼球钝挫伤术后随访视力较术前明显提高 ,差异有显著性意义 (P <0 0 1 ) ,伤后各时间段的手术效果的差异无显著性意义 (P>0 0 5)。术前不合并视网膜脱离的 2 8眼最终全部痊愈 ;合并视网膜脱离的 2 9眼中 ,术后 5眼因增生性玻璃体视网膜病变 (Prolifer ativevitreoretinopathy ,PVR)、1眼因新裂孔致视网膜再脱离 ,行二次玻璃体切除手术后 4眼视网膜复位 ,2眼失败。手术主要并发症是高眼压 (高于 30mmHg占 36 8% ,2 1 / 57)和复发性视网膜脱离 (2 0 7% ,6/ 2 9)。结论 严重眼球钝挫伤后玻璃体视网膜手术疗效显著 ,PVR是手术失败的主要原因 ,术后应重点防治高眼压
Objective To observe the curative effect of vitreoretinal surgery on serious eyeball blunt contusion and to analyze the causes of surgical failure. Methods A total of 57 eyes (57 eyes) with serious eyeball blunt trauma were treated with vitreoretinal surgery. The relationship between the time from injury to operation and the curative effect were retrospectively analyzed. The complications of the operation were also analyzed. Results The vitreoretinal surgery had a significant improvement in the visual acuity of follow-up after serious eyeball contusion (P <0.01), but there was no significant difference in operative effect between the two groups (P> 0) 0 5). In the 29 eyes with conjunctival detachment, 5 eyes had retinal detachment due to proliferative vitreoretinopathy (PVR). One eye had retinal detachment due to neovascular hole. Retinal reattachment occurred in 4 eyes after secondary vitrectomy, and 2 eyes failed. The major complications of surgery were high intraocular pressure (36.8% over 30 mmHg, 21/57) and recurrent retinal detachment (27%, 6/2 9). Conclusion Severe eyeball blunt traumatic vitreoretinal surgery significant effect, PVR is the main reason for the failure of surgery, should focus on prevention and treatment of intraocular hypertension