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目的探讨玻璃体切除联合晶状体切除术治疗眼挫伤致晶状体后脱位的临床疗效。方法对22眼外伤程度、手术方式及效果等资料进行回顾性分析。结果除晶状体后脱位以外,合并损伤主要包括不同程度前房角后退10眼,视网膜震荡伤8眼,玻璃体疝6眼,前房或玻璃体积血5眼,外伤性瞳孔散大4眼,虹膜根部断离3眼,视网膜脱离3眼,视网膜裂孔2眼,视网膜脉络膜裂伤1眼。22眼均施行玻璃体切除联合晶状体切除术,术中同时眼内激光封孔和C3F8气液交换5眼,小梁切除3眼,硅油注入1眼,虹膜根部断离修补1眼,一期植入前房型人工晶状体3眼。术前矫正视力≤0.15。术后随访1~27月,矫正视力≥0.2者13眼。结论术前充分评估眼外伤程度,有利于合理选择手术时机和手术方式;玻璃体切除联合晶状体切除术能有效摘出脱位晶状体,可同时进行裂孔封闭、视网膜复位、小梁切除、虹膜断离根部修补、人工晶状体植入等操作,最大程度修复创伤。
Objective To investigate the clinical effect of vitrectomy combined with lensectomy for the treatment of ocular contusion after posterior lens dislocation. Methods Twenty-two eyes were retrospectively analyzed on the degree of trauma, the operation method and effect. Results In addition to the posterior lens dislocation, the combined injuries mainly included varying degrees of anterior chamber angle retrograde 10, retinal injury 8, vitreous hernia 6, anterior chamber or vitreous hemorrhage 4, traumatic mydriasis 4, iris root Broken off from 3 eyes, retinal detachment 3 eyes, retinal tears 2 eyes, retinal choroid laceration 1 eye. 22 eyes were performed vitrectomy combined with lensectomy, while intraoperative laser sealing and C3F8 gas-liquid exchange in 5 eyes, trabeculectomy 3 eyes, silicone oil injection in 1 eye, the iris root off repaired one eye, an implantation Anterior chamber intraocular lens 3 eyes. Preoperative corrected visual acuity ≤0.15. Follow-up 1 ~ 27 months after surgery, corrected visual acuity ≥ 0.2 in 13 eyes. Conclusion Preoperative assessment of the degree of ocular trauma is conducive to a reasonable choice of operation timing and surgical methods; vitrectomy combined with lensectomy can effectively remove the dislocation of the lens, at the same time the hole closed, the retina, trabeculectomy, iris repair, Intraocular lens implantation and other operations, to maximize the repair of trauma.