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目的探讨眼外伤角膜浑浊状态下玻璃体视网膜手术的手术时机、方法及技巧。方法对65例(67眼)眼外伤角膜浑浊(≥2/5面积)术中采用刮除角膜上皮、应用棱镜式接触镜、转动眼位及头位、巩膜外顶压及临时人工角膜等不同的手术方法和技巧,完成玻璃体视网膜手术。结果本组67眼全部顺利完成手术中各项操作,其中9眼眼内异物均在直视下摘出。术后有13眼(19.40%)视网膜脱离,其中6眼再次手术成功,7眼放弃手术。随访6~12个月,最终视力≥眼前数指者39眼(58.21%),眼球萎缩9眼(13.43%)。同时行穿透性角膜移植3眼,2眼植片透明,1眼植片浑浊。结论眼外伤角膜浑浊状态下,应尽量采取相应措施完成玻璃体视网膜手术,以挽救视功能或保留眼球。
Objective To investigate the timing, methods and techniques of vitreoretinal surgery under corneal opacity. Methods 65 cases (67 eyes) of traumatic corneal opacity (≥2 / 5 area) were treated with the procedure of scraping the corneal epithelium. Prism contact lenses, rotational position and head position, scleral buckling and temporary artificial cornea were used The surgical methods and techniques to complete the vitreoretinal surgery. Results All 67 eyes in this group were successfully performed the operation, among which 9 eyes were removed under direct vision. There were 13 eyes (19.40%) with retinal detachment after operation. Among them, 6 had reoperation successfully and 7 gave up surgery. During the follow-up of 6 to 12 months, the final visual acuity was 39 eyes (58.21%) of the anterior fingers and 9 eyes (13.43%) of the atrophy of the eyes. At the same time, penetrating keratoplasty 3 eyes, 2 eyes were transparent, 1 eyes were cloudy. Conclusion Under the condition of ocular trauma and corneal opacity, vitrectomy should be taken as much as possible to save visual function or preserve the eyeball.