[关键词]
[摘要]
目的:探讨折叠式人工玻璃体球囊(FCVB)植入术治疗重度眼外伤患者的有效性和安全性,初步分析睫状体功能对FCVB植入手术的影响。
方法:回顾性分析。纳入2018-01/2020-07在南方医科大学附属小榄人民医院接受FCVB植入手术的重度眼外伤患者10例10眼。根据患者术前检查结果进行睫状体功能评分,评分≤5分者判定睫状体功能衰竭:其中评分>5分者8眼,评分≤5分者2眼。术后随访1~31mo,检查患者BCVA、眼压,观察前房、视网膜复位情况、球囊位置及术后不良反应。
结果:纳入9眼无晶状体眼患者FCVB植入过程顺利,术中无并发症; 1眼有晶状体眼患者在FCVB植入过程中出现上方部分虹膜根部离断。至末次随访,所有患者FCVB位置良好,视网膜复位率100%。无严重不良事件发生。术前和末次随访的BCVA和眼压比较均无差异(P>0.05)。术前睫状体评分>5分组(8眼)中,有2眼各补充手术1次,1眼补充手术2次。睫状体功能评分≤5分组(2眼),1眼补充手术1次,1眼补充手术5次。
结论:FCVB可用于治疗重度眼外伤患者,但不能有效提高患者视力。患者术前的睫状体功能状态可能与FCVB植入术后持续性低眼压、浅前房相关。
[Key word]
[Abstract]
AIM: To investigate the clinical efficacy and safety of the foldable capsular vitreous body(FCVB)implantation in the treatment of severe ocular trauma and also explore the effect of ciliary body function on the FCVB implantation.
METHODS: This study retrospectively analyzed 10 cases(10 eyes)with severe ocular trauma which had accepted FCVB implantation performed in Affiliated Xiaolan People's Hospital, Southern Medical University from January 2018 to July 2020. Ciliary body function was judged by score which was made by preoperative examination results. The case which scored 5 or less was studied as ciliary failure: 8 eyes scored more than 5, 2 eyes scored 5 or less. Followed up for 1-31mo, the postoperative best corrected visual acuity(BCVA)and intraocular pressure, anterior chamber, retinal reattachment, FCVB condition and adverse reactions were observed.
RESULTS: The operations of 9 eyes with aphakia eyes were successful. Iridodialysis occurred during the operation of 1 eye with lens. Retinal reattachment was found in all 10 eyes, and the position of FCVB in all patients was proper. There was no severe adverse reactions. Comparing the preoperative and postoperative BCVA and intraocular pressure, the difference was not statistically significant(P>0.05). In the group(8 eyes)that ciliary body function scored more than 5, 2 eyes had a supplementary operation individually, 1 eye underwent 2 supplementary operations. In the group(2 eyes)which scored 5 or less, supplementary operations were performed 5 times in 1 eye, only 1 time in the other one case.
CONCLUSION: Implantation of FCVB is a safe option to treat severe ocular trauma. But the postoperative visual acuity cannot be improved. The ciliary body function associates with persistent intraocular hypotension and shallow anterior chamber after FCVB implantation.
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[基金项目]
广东省医学科学技术研究基金项目(No.B2019230); 中山市科技计划重大项目(No.2016B1010)