外伤性脉络膜上腔出血合并视网膜脱离的临床观察及手术疗效分析
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摘要
目的分析外伤性脉络膜上腔出血合并视网膜脱离的临床特点及手术治疗效果。方法回顾性分析外伤性脉络膜上腔出血合并视网膜脱离患者11例(11只眼),均行Ⅱ期玻璃体切除联合后巩膜切开术引流脉络膜上腔积血,术中玻璃体腔硅油填充。术后观察眼部表现及视网膜复位率等情况。结果术后随访6～30个月,11只眼均成功引流脉络膜上腔积血,视网膜平伏在位,大多数眼球均可保存,其中6只眼视力较术前不同程度提高。结论在Ⅰ期手术规范处理的条件下,经Ⅱ期引流脉络膜上腔积血及玻璃体切除、视网膜复位后,大多数严重的外伤性脉络膜上腔出血合并视网膜脱离的患者均可保留眼球,部分患者可获得视功能改善。
Objective To analyze the clinical characteristics and surgical effect of traumatic suprachoroidal hemorrhage with retinal detachment. Methods A retrospective analysis method was used to analyze the data of 11 eyes in 11 patients diagnosed with traumatic suprachoroidal hemorrhage and retinal detachment. All underwent vitrectomy combined with posterior sclerectomy to drain the choroidal hemorrhage and silicone oil tamponade. The ocular manifestations and retinal reposition rate were observed after operation. Results All the patients were followed up for 6 ～ 30 months. Eleven patients had successful drainage of choroidal hemorrhage and the retina was attached,and most eyeballs could be preserved. Six cases had improved visual acuity to varying degrees compared with that before surgery. Conclusions Under the condition of the first-stage surgical specification processing,after transscleral drainage,vitrectomy,and silicone oil tamponade,the most patients with severe traumatic suprachoroidal hemorrhage and retinal detachment can retain the eyeballs,and the visual acuity can be improved.
Objective To analyze the clinical characteristics and surgical effect of traumatic suprachoroidal hemorrhage with retinal detachment. Methods A retrospective analysis method was used to analyze the data of 11 eyes in 11 patients diagnosed with traumatic suprachoroidal hemorrhage and retinal detachment. All underwent vitrectomy combined with posterior sclerectomy to drain the choroidal hemorrhage and silicone oil tamponade. The ocular manifestations and retinal reposition rate were observed after operation. Results All the patients were followed up for 6 ～ 30 months. Eleven patients had successful drainage of choroidal hemorrhage and the retina was attached,and most eyeballs could be preserved. Six cases had improved visual acuity to varying degrees compared with that before surgery. Conclusions Under the condition of the first-stage surgical specification processing,after transscleral drainage,vitrectomy,and silicone oil tamponade,the most patients with severe traumatic suprachoroidal hemorrhage and retinal detachment can retain the eyeballs,and the visual acuity can be improved.
引文
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[2]Wang YN,Shen LJ,Wang CG,et al.Prognosis of traumatic eyes with no light perception undergone vitrectomy and analysis of risk factors[J].Zhonghua Yan Ke Za Zhi,2007,43(4):340-345.
[3]Chandra A,Xing W,Kadhim MR,et al.Suprachoroidal hemorrhage in pars plana vitrectomy:risk factors and outcomes over 10 years[J].Ophthalmology,2014,121(1):311-317.
[4]Sukpen I,Stewart JM.Acute Intraoperative Suprachoroidal Hemorrhage during Small-Gauge Pars Plana Vitrectomy[J].Retin Cases Brief Rep,2018,12,1:9-11.
[5]Learned D,Eliott D.Management of Delayed Suprachoroidal Hemorrhage after Glaucoma Surgery[J].Semin Ophthalmol,2018,33(1):59-63.