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为探讨玻璃体切割术在治疗儿童眼后节外伤中的作用和效果,对45例年龄16岁以下儿童的46只眼后节外伤行经平部玻璃体切割治疗的结果进行回顾性分析。46只眼中6只眼为单纯玻璃体切割,40只眼联合巩膜环扎、外加压、和/或气液交换、或硅油内充填,其中17只眼联合晶体切割。结果:34只眼(73.91%)获得手术成功,其中锐器伤成功率为85.71%、钝伤55.56%、爆炸伤及球内异物78.57%、眼内炎66.67%。46只眼中13只眼(28.26%)合并视网膜脱离,术后6只眼(46.15%)视网膜复位。视网膜脱离是眼外伤手术失败的主要原因,且其特征为前部增殖性玻璃体视网膜病变(PVR)。指出:玻璃体切割术对儿童眼后节外伤具有重要治疗价值;联合视网膜复位术治疗外伤性视网膜脱离是全面提高儿童眼外伤视力预后的关键。同时对儿童眼后节外伤的临床特点及影响预后的诸问题进行了详细的分析。
To investigate the role and effect of vitrectomy in treating traumatic ocular trauma in children, the results of 46 vitreous hemorrhage in 45 children under the age of 16 underwent pars plana vitrectomy were analyzed retrospectively. Six of the 46 eyes were vitrectomy, 40 eyes combined with scleral cerclage, external compression, and / or gas-liquid exchange, or silicone oil filling, of which 17 eyes combined with crystal-cutting. Results: 34 eyes (73.91%) had successful operation. The successful rate of sharp injury was 85.71%, 55.56% of blunt trauma, 78.57% of blast injury and 66.67% of endophthalmitis. Retinal detachment was found in 13 eyes (28.26%) of 46 eyes and retina in 6 eyes (46.15%). Retinal detachment is the leading cause of ocular trauma surgery failure and is characterized by anterior proliferative vitreoretinopathy (PVR). It is pointed out that vitrectomy has important therapeutic value in children with traumatic ocular trauma. Combining retinal reattachment in treating traumatic retinal detachment is the key to improve visual prognosis of children with ocular trauma. At the same time, the clinical features of children’s ocular trauma and prognosis of the problems were analyzed in detail.