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目的评价玻璃体手术治疗合并脉络膜损伤的外伤性视网膜脱离的效果。方法对1995年至2005年间经玻璃体手术治疗1075只外伤眼进行回顾性分析,外伤性视网膜脱离合并浆液性脉络膜脱离、出血性脉络膜脱离(含外伤性脉络膜分离)或视网膜下出血在内的不同类型脉络膜损伤共41例41只眼(3.8%),采用闭合式玻璃体手术进行治疗,统计比较手术预后。结果视网膜复位38只眼(92.7%),最终视力大于0.1者10只眼(24.4%);手术后视力提高者共29只眼(70.7%),其中合并视网膜下出血组14只眼(87.5%,14/16),合并浆液性脉络膜脱离组12只眼(75.0%,12/16),合并出血型脉络膜脱离组3只眼(33.3%,3/9),三组患眼的视力提高率χ2=8.394,P=0.015,P<0.05。最终黑朦6只眼,均为出血型脉络膜脱离者。17只低眼压眼中8只眼(47.1%)需持续硅油填充,出血型脉络膜脱离5只眼(55.6%,5/9)。结论合并脉络膜损伤的外伤性视网膜脱离玻璃体手术处理得当可获得较好的结果,其中合并视网膜下出血者手术预后较好;合并出血型脉络膜脱离眼预后较浆液型明显差,但也并非眼球摘除适应证。严重外伤性脉络膜分离眼预后较差常为低眼压需长期硅油填充。
Objective To evaluate the effect of vitrectomy on traumatic retinal detachment with choroidal injury. Methods A retrospective analysis of 1075 traumatic eyes treated by vitreous surgeries between 1995 and 2005 was conducted. Traumatic retinal detachment combined with serous choroidal detachment, different types of hemorrhagic choroidal detachment (including traumatic choroidal detachment) or subretinal hemorrhage Choroidal injury in 41 cases 41 eyes (3.8%), closed vitreous surgery for treatment, statistical comparison of surgical outcomes. Results Retinal reattachment in 38 eyes (92.7%) and final visual acuity in 0.1 eyes (24.4%) were seen in 29 eyes (70.7%). Among 14 eyes (87.5%) with subretinal hemorrhage, , 14/16). Twelve eyes (75.0%, 12/16) had serous choroidal detachment and 3 eyes (33.3%, 3/9) had hemorrhagic choroidal detachment. The improvement of visual acuity χ2 = 8.394, P = 0.015, P <0.05. The final 6 black eyes, are bleeding choroidal detachment. Eight eyes (17.1%) underwent 17 eyes with low intraocular pressure (IOP), requiring continuous silicone oil filling. Five patients (55.6%, 5/9) had hemorrhagic choroidal detachment. Conclusions The traumatic retinal detachment combined with traumatic retinal detachment with vitreous surgery can get better results. The prognosis of patients with combined subretinal hemorrhage is better. The prognosis of combined hemorrhagic choroidal detachment is significantly worse than that of the serous type. However, certificate. Severe traumatic choroidal septum poor prognosis often low intraocular pressure need long-term silicone oil filling.