不同时期微创玻璃体切除术治疗伴有视网膜脱离的开放性眼外伤的疗效比较
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中山市重大科技计划项目(No.2016B1010)


Minimally invasive vitrectomy for open ocular trauma with retinal detachment at different stages
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Science and Technology Plan Projects of Zhongshan(No.2016B1010)

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    摘要:

    目的:研究不同手术时期行Ⅱ期微创玻璃体手术治疗伴有视网膜脱离的开放性眼外伤的临床疗效。

    方法:回顾性分析2013-12/2018-06中山市小榄人民医院眼科收治的合并视网膜脱离的开放性眼外伤患者共41例41眼,按照Ⅱ期玻璃体切除术时间分为:早期组(伤后≤6d)24眼,常规组(伤后7~14d)17眼。术后随访以6mo为节点,比较两组术后视网膜复位率、增殖性玻璃体视网膜病变(TPVR)发生率、视力、并发症情况。

    结果:早期组视网膜复位率为92%,常规组为76%,两者无差异(P=0.692)。早期组TPVR发生率低于常规组(P=0.014),术后视力提高程度好于常规组(U=119.5,P=0.0018)。两组并发症发生率无差异。

    结论:合并视网膜脱离的开放性眼外伤患者伤后6d内行Ⅱ期玻璃体切除术预后相对较好。

    Abstract:

    AIM:To study the clinical efficacy of phase Ⅱ minimally invasive vitreous surgery in different stages in treatment of open ocular trauma with retinal detachment.

    METHODS: A retrospective analysis was performed on 41 patients(41 eyes)with open eye trauma combined with retinal detachment from December 2013 to June 2018 in the Ophthalmology Department of Xiaolan People's Hospital of Zhongshan. According to the opportunity of phase Ⅱ vitrectomy, 41 eyes were divided into two groups: 24 eyes in the early group(6d after injury)and 17 eyes in the conventional group(7-14d after injury). Postoperative follow-up with 6mo as the time point, the retinal reattachment rate, TPVR incidence, visual acuity and complications were compared between the two groups.

    RESULTS: The retinal reduction rate was 92% in the early group and 76% in the conventional group, and the difference was not statistically significant, there was no statistical difference(P=0.692)in retinal reduction rate between the two groups. The incidence of TPVR in the early group was lower than that in the conventional group(P=0.014). The improvement of postoperative visual acuity in early group was better than the conventional group(U=119.5, P=0.0018). There was no significant difference in complications between the two groups.

    CONCLUSION: Open ocular trauma patients with retinal detachment have better prognosis after phase Ⅱ vitrectomy within 6d after injury than 7-14d.

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李文庆,杨新怀,黄洁蕾,等.不同时期微创玻璃体切除术治疗伴有视网膜脱离的开放性眼外伤的疗效比较.国际眼科杂志, 2019,19(8):1431-1434.

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  • 收稿日期:2019-03-18
  • 最后修改日期:2019-07-03
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  • 在线发布日期: 2019-07-25
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