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目的:探讨外伤性睫状体解离及其并发症的临床治疗效果。方法:我院1993-01/2003-06共收治钝挫伤所致的外伤性睫状体解离19例(19眼),男12例,女7例,年龄6～44(平均25)岁。就诊时眼压为0～10平均2.42)mmHg。14例行睫状体显微缝合固定术,其中3例联合巩膜环扎局部冷凝;4例行改良的睫状体缝合固定术—平行于角巩膜缘、不切透深层巩膜,并重叠缝合。3例行保守治疗,2例行氩激光光凝。结果:在14例行睫状体显微缝合固定术病例中,一次手术成功者9例(64.3%);二次手术成功者3例21.4%);三次手术成功者2例(14.3%)。术后随访时间1月～8a,平均眼压11.24mmHg,较术前有明显提高(Wilcoxon-Mann-Whitney, P =0.0052)。最后随访视力较术前有明显提高(Wilcoxon signrank, P =0.012)。结论:睫状体缝合固定术是有效的治疗外伤性睫状体解离的手段;改良的手术方法可进一步提高成功率;超声生物显微镜可准确诊断外伤性睫状体解离,对手术成功有重要帮助。
Objective: To investigate the clinical effect of traumatic ciliary body dissociation and its complications. Methods: 19 cases (19 eyes) with traumatic ciliary body dissociation caused by blunt trauma were treated in our hospital from January 1993 to June 2003, including 12 males and 7 females, aged from 6 to 44 (average 25 years). Intraocular pressure at treatment is 0 to 10 an average of 2.42) mmHg. 14 cases of ciliary body microsurgical suture fixation, including 3 cases of scleral conjunctival local condensation; 4 cases of modified ciliary suture fixation - parallel to the corneal limbus, not through the deep sclera, and overlapping suture. 3 routine conservative treatment, 2 cases of argon laser photocoagulation. Results: In 14 cases of microsurgical fixation of ciliary body, 9 cases (64.3%) were successful in one operation, 3 cases (21.4%) in secondary operation, and 2 cases (14.3%) were successful in three operations. The follow-up time from January to August was 11.24mmHg, which was significantly higher than that before operation (Wilcoxon-Mann-Whitney, P = 0.0052). The final follow-up visual acuity was significantly higher than that before the operation (Wilcoxon signrank, P = 0.012). Conclusion: Ciliary suture fixation is an effective method to treat traumatic ciliary body dissociation. Improved surgical methods can further improve the success rate. Ultrasound biomicroscopy can accurately diagnose traumatic ciliary body dissociation. Important help.