目的 :探讨玻璃体手术治疗眼外伤出血性脉络膜脱离的手术时机、处理方法及临床效果。方法 :对 4例、4眼严重眼外伤合并出血性脉络膜脱离患者 ,于伤后 7～ 2 0d ,平均 13d行玻璃体手术。术前视力为光感～眼前指数 ,眼压 3.7～ 7.0mmHg ,术中先用 30号针头自角膜缘注入灌注液 ,指测眼压Tn -T+ 1,在常规扁平部三切口处 ,先穿透巩膜 ,引流脉络膜上腔血液 ,引流后再行闭合式玻璃体切除术 ,术中彻底切除玻璃体 ,同时联合剥膜 ,气液交换 ,行眼内激光及视网膜复位术。 2只眼术中应用重水 ,2只眼注入硅油 ,4眼均行晶状体切除。结果 :随访 4～ 5个月 ,矫正视力分别为 0 .4、0 .2 5、0 .0 4、光感。眼压 12～ 19mmHg。 4眼视网膜在位 ,1眼术后 3个月取出硅油 ,术后 1个月视网膜在位。结论 :严重眼外伤合并出血性脉络膜脱离应于伤后 7～ 15d行玻璃体手术。术中充分引流液化的脉络膜积血 ,彻底切除玻璃体 ,是治疗眼外伤出血性脉络膜脱离的有效方法 Objective: To investigate the timing, treatment and clinical effect of vitrectomy for the treatment of ocular trauma hemorrhagic choroidal detachment. Methods: Four patients (4 eyes) with severe ocular trauma accompanied by hemorrhagic choroidal detachment were treated with vitreous surgery on average from 13 days to 20 days after injury. Preoperative visual acuity ~ light index ~ anterior index, intraocular pressure 3.7 ~ 7.0mmHg, intraoperative first with a 30-gauge needle from the limbus perfusion fluid infusion, referring to intraocular pressure Tn-T +1, at the common flat three incisions, wear Through the sclera, drainage of choroidal blood, drainage and then closed vitrectomy, intraoperative radical removal of the vitreous, combined with stripping, gas-liquid exchange, intraocular laser and retinal reattachment. Two eyes were treated with heavy water, 2 eyes were injected with silicone oil, and 4 eyes underwent lensectomy. Results: The follow-up of 4 to 5 months, corrected visual acuity were 0. 4,0 .2 5,0. 0 4, light perception. Intraocular pressure 12 ~ 19mmHg. Retinal reattachment was performed in 4 eyes. One eye removed the silicone oil 3 months after operation and the retina was in place 1 month after surgery. Conclusion: Severe ocular trauma with hemorrhagic choroidal detachment should be performed on vitreous surgery 7 ~ 15 days after injury. Intraoperative drainage of liquefied choroidal hemorrhage, complete removal of the vitreous, is an effective method for the treatment of ocular trauma hemorrhagic choroidal detachment