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目的 :探讨联合手术治疗复杂性眼球穿孔伤、眼前段遭到严重破坏者的手术方法及临床效果。方法 :采用穿透性角膜移植(penetrating keratoplasty,PK)联合前段玻璃体切除及人工晶体巩膜缝线固定三联手术治疗复杂性眼球穿孔伤患者 2 2例 (2 2眼 ) ,术后随访 3～ 2 8个月。结果 :术后 6个月矫正视力≥ 0 .3者 16眼 ,0 .2者 2眼 ,0 .15者 2眼 ,0 .1者 1眼 ,0 .0 5者 1眼。单眼脱残率为 72 % ,脱盲率为 95 % ;植片透明率为 91%。主要并发症是植片排异反应、继发性青光眼、角膜屈光异常。结论 :PK联合前段玻璃体切除及人工晶体巩膜缝线固定三联手术是一种安全可靠的手术方法 ,具有增视、眼前段重建、美容及避免多次手术的痛苦等多重临床意义
Objective: To explore the surgical methods and clinical effects of combined surgery for complicated perforation injury of the eye and severely damaged anterior segment. METHODS: Twenty-two patients (22 eyes) with complicated orbital perforation were treated with penetrating keratoplasty (PK) combined with anterior vitrectomy and intraocular lens scleral suture fixation. The patients were followed up for 3 to 28 Months. Results: At 6 months after operation, corrected visual acuity was ≥0.3 in 16 eyes, 0.2 eyes in 2 eyes, 0.15 eyes in 2 eyes, 0.1 eyes in 1 eye and 0.05 eyes in 1 eye. Monocular disabling rate was 72%, blinding rate of 95%; graft transparency was 91%. The main complication is rejection of the graft, secondary glaucoma and corneal refractive abnormalities. Conclusions: The combination of PK anterior vitrectomy and intraocular lens scleral suture fixation triple operation is a safe and reliable operation method, with multiple clinical significance of increased vision, anterior segment reconstruction, cosmetic and to avoid the pain of multiple surgeries