两种手术方式治疗后段眼内磁性异物伤的疗效及预后因素的分析
发布时间：2018-12-29 16:07
【摘要】：目的评价经玻璃体切除手术和经巩膜切口或非玻璃体切除取出异物手术治疗后段眼内磁性异物伤的临床疗效,以及对玻璃体切除手术治疗后视力预后的主要影响因素。 方法回顾性分析2006年6月至2010年12月,后段眼内异物伤住院治疗换者113例113眼,其中经玻璃体切除联合异物取出者61眼,非玻璃体切除取出眼内异物者52眼。并分别对手术方式、术前最佳矫正视力(BCVA)、异物大小、异物位置、外伤严重程度、手术时间、视网膜脱离(RD)与术后BCVA的关系进行分析。统计软件采用SPSS 13.0 for Windows,显著性检验水准以P0.05为有显著性差异。 结果 1.经玻璃体切除手术眼内异物取出成功率为100%,经巩膜切口取出异物手术眼内异物取出成功率为86.54%。 2.两组病例手术前BCVA分布及外伤程度无明显统计学差异。经玻璃体切除手术治疗组70.49%的患眼术前BCVA力低于0.1,非玻璃体切除治疗组75.00%的患眼术前BCVA低于0.1。 3.经玻璃体切除治疗组患者术后BCVA0.1者48眼(78.69%),≥0.5者18眼(29.51%),玻璃体切除治疗组手术前后BCVA有显著统计学差异。非玻璃体切除组术后BCVA0.1者5眼(5.77%),≥0.5者2眼(3.85%),非玻璃体切除组手术前后BCVA无统计学意义。两组患者手术后视力分布统计学上有显著差异(Z二一6.453,P=0.0000.05)。 4.经玻璃体切除手术治疗组术后并发症少于非玻璃体切除手术治疗组,P0.05,有统计学意义。玻璃体切除手术治疗组术后发生RD者4眼,外伤性增生性玻璃体视网膜病变(tPVR)者3眼,玻璃体出血者1眼；6眼(9.84%)再次行玻璃体切除手术,术后视网膜均复位。非玻璃体切除治疗组术后发生RD者24眼,tPVR者26眼,玻璃体出血者36眼,眼内炎者3眼；43眼(82.69%)于术后5-20d行Ⅱ期玻璃体切割或联合视网膜复位手术,2眼视网膜无法复位,1眼眼内容物剜除。 5.玻璃体切除联合眼内异物取出手术后影响BCVA的因素包括伤口长度、术前BCVA、手术时机、RD、眼内炎、异物损伤区域。 结论 1.后段眼内异物伤眼,经玻璃体切除手术治疗较经巩膜路径手术取出异物的取出率高、术后视力恢复好、并发症少。 2.对伴有眼内炎和视网膜脱离的后段眼内异物伤患者,应首选玻璃体切除手术治疗。 3.玻璃体切除取出后段眼内异物手术后,影响BCVA的主要相关因素包括伤口长度、术前BCVA、手术时机、视网膜脱离、眼内炎、异物损伤区域。 4.RD和tPVR是眼内异物伤及经玻璃体切除手术取出异物后常见的严重并发症,视力预后较差。 5.后段眼内异物伤合并眼内炎者宜应尽早行玻璃体切割手术治疗,但术后视力恢复极差。
[Abstract]:Objective to evaluate the clinical effect of transvitrectomy and scleral incision or non-vitrectomy in the treatment of posterior intraocular magnetic foreign body injury and the main factors influencing the prognosis of visual acuity after vitrectomy. Methods 113 cases (113 eyes) with posterior intraocular foreign body injury were treated retrospectively from June 2006 to December 2010. Among them, 61 eyes were removed by vitrectomy combined with foreign body, and 52 eyes were removed intraocular foreign body by non-vitrectomy. The relationship between (BCVA), foreign body size, location of foreign body, severity of trauma, operation time, retinal detachment (RD) and postoperative BCVA were analyzed respectively. Statistical software using SPSS 13.0 for Windows, significant test level of P0.05 as a significant difference. Result 1. The success rate of intraocular foreign body removal was 100% after vitrectomy and 86.54% through scleral incision. 2. There was no significant difference in the distribution of BCVA and the degree of trauma between the two groups before operation. The preoperative BCVA strength of 70.49% of the affected eyes was lower than 0.1 in the vitrectomy group, and the preoperative BCVA of 75.00% of the non-vitrectomy group was lower than 0.1. 3. BCVA0.1 in 48 eyes (78.69%) and 鈮，
本文编号：2395041
[Abstract]:Objective to evaluate the clinical effect of transvitrectomy and scleral incision or non-vitrectomy in the treatment of posterior intraocular magnetic foreign body injury and the main factors influencing the prognosis of visual acuity after vitrectomy. Methods 113 cases (113 eyes) with posterior intraocular foreign body injury were treated retrospectively from June 2006 to December 2010. Among them, 61 eyes were removed by vitrectomy combined with foreign body, and 52 eyes were removed intraocular foreign body by non-vitrectomy. The relationship between (BCVA), foreign body size, location of foreign body, severity of trauma, operation time, retinal detachment (RD) and postoperative BCVA were analyzed respectively. Statistical software using SPSS 13.0 for Windows, significant test level of P0.05 as a significant difference. Result 1. The success rate of intraocular foreign body removal was 100% after vitrectomy and 86.54% through scleral incision. 2. There was no significant difference in the distribution of BCVA and the degree of trauma between the two groups before operation. The preoperative BCVA strength of 70.49% of the affected eyes was lower than 0.1 in the vitrectomy group, and the preoperative BCVA of 75.00% of the non-vitrectomy group was lower than 0.1. 3. BCVA0.1 in 48 eyes (78.69%) and 鈮，
本文编号：2395041
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