摘要目的 比较视网膜切开术与玻璃体切除联合巩膜扣带术对开放性眼球伤预后的影响.方法 临床病例对照研究.对2009年3月至2013年7月在西安市第四医院眼科住院的开放性眼外伤患者,根据眼部损伤严重性及伤口长度、玻璃体视网膜嵌顿位置、是否合并视网膜脱离,将11例玻璃体切割联合巩膜扣带术患者(巩膜扣带组)和11例玻璃体切割联合视网膜切开患者(视网膜切开组)进行配对;比较两组患者视网膜复位率、并发症发生率及矫正视力.结果 巩膜扣带组视网膜复位率81.82％ (9/11),视网膜切开组视网膜复位率63.64％ (7/11),差异无统计学意义(P =0.632).巩膜扣带组6只眼(54.54％)、视网膜切开组4只眼(36.36％)术后视力提高,差异无统计学意义(P=0.361).术后眼内炎症反应发生率,视网膜切开组为45.45％ (5/11),巩膜扣带组无;术后出血发生率,巩膜扣带组为9.09％(1/11),视网膜切开组为36.36％ (4/11).结论 在开放性眼外伤中,玻璃体视网膜手术联合巩膜扣带术比视网膜切开术,术后出血更少,炎症反应更轻和更好的视网膜复位率.

abstractsObjective To evaluate the anatomic and functional outcomes of pars plana vitrectomy (PPV) combined with scleral buckling (SB) versus retinectomy in treating eyes with posterior segment open globe injuries and retina incarceration.Methods Twenty-two eyes with posterior segment open globe injuries and retina incarceration were identified,and 11 of them (group A) underwent the combined treatment of PPV with SB,matched another 11 eyes treated with retinectomy (group B).Both groups were equivalent in the three matching factors:the severity of injury (including wound length),location of the incarceration site,presence of retinal detachment.Anatomic reattachment of the retina and best-corrected visual acuity (BCVA) were measured at the time of 12 months after operation.Results Patients in group A demonstrated a significant improvement in anatomic retinal attachment compared with patients in group B (81.82％ vs 63.64％) at the time of 12 months after operation (P =0.632).BCVA were improved in 6 eyes (54.54％) of group A and 4 eyes (36.36％) in group B at the time of 12 months after operation (P =0.361).However,eyes in group B had higher rates of postoperation hemorrhage (45.45％ vs 0) and postoperation inflammation (36.36％ vs 9.09％).Conclusions For eyes with posterior segment open globe injuries and retina incarceration,patients with PPV and SB demonstrate a significant improvement in anatomical and function outcomes,and less postoperation complications compared with patients with retinectomy.