Efficacy of combined vitreous surgery and choroidal suture fixation on choroidal avulsion.
Efficacy of combined vitreous surgery and choroidal suture fixation on choroidal avulsion.
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DOI：
10.3969/j.issn.1000-4432.2011.03.004
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发表时间：
2011-09-01
期刊：
影响因子：
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通讯作者：
Ye, Panpan
中科院分区：
文献类型：
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作者：
Ma, Jin;Tong, Yuhua;Ye, Panpan
目得：目的：探讨玻璃体手术联合脉络膜缝合固定治疗脉络膜撕脱伤的可行性和疗效。方法：回顾性分析21例（21眼）开放性眼外伤继发脉络膜撕脱伤患者，均行一期眼球壁闭合术。术前眼压3 ~ 7.5mmHg（平均5.1±1.1mmHg），有或怀疑有光感。玻璃体视网膜手术联合脉络膜缝合固定术于伤后4 ~ 21天（平均9.41±2.7天）完成。结果：术后随访3 ~ 9个月，平均（5.5±1.5）个月。还观察到视网膜增殖/脱离、嵌顿和/或部分视网膜丧失。术中分离并松解视网膜，在脉络膜撕脱区行巩膜外缝线固定联合眼内光凝和硅油填充。在一些患者中还引入了睫状体上的缝线固定。术后1个月，16眼（16/21，76.19%）脉络膜完全复位，5眼部分复位。随访结束时，4/16眼（25%）脉络膜部分再脱离，12眼（12/21，57.1%）完全复位，9眼（9/21，33.34%）部分复位。结论：经巩膜缝线固定术治疗脉络膜撕脱伤是一种可靠的方法，尤其是提高了脉络膜的复位率，术后1个月随访时脉络膜完全复位率与术后1个月比较差异无统计学意义（χ 2检验，P0. 05）。
PURPOSE: To evaluate the feasibility and efficacy of combined vitreous surgery and choroidal suture fixation on choroidal avulsion.METHODS: A total of 21 patients (21 eyes) with choroidal avulsion, secondary to open eye trauma and a history of one-stage eyeball wall closure were retrospectively evaluated in the present study. Preoperative findings included 3 to 7.5 mmHg (averagely 5.1±1.1mmHg) of intraocular pressure and presence/suspicion of visual light perception. Vitreo-retinal surgery in combination with choroidal suture fixation was conducted for these patients at 4 to 21 days averagely 9.41±2.7 days) after the trauma. The postoperative follow-up lasted for 3 to 9 months (averagely 5.5±1.5 months).RESULTS: The intraoperative findings indicated several choroid residuals with different densities attached on the sclera at the choroidal detachment area. Retinal proliferation/detachment, incarceration and/or partial retinal loss were also observed. Intraoperatively, the retina was separated and released, and the suture fixation outside the sclera in combination with intraocular photocoagulation and silicone oil filling were performed at the avulsed choroidal area. The suture fixation on the ciliary body was also introduced in some of the patients. At one month posteoperatively, a complete choroidal reattachment was achieved in 16 eyes (16/21, 76.19%) and partial reattachment in the remaining 5 eyes. At the end of follow-up, partial choroidal redetachment was observed in 4 of 16 eyes (25%), resulting in complete reattachment in 12 eyes (12/21, 57.1％) and partial reattachment in 9 eyes (9/21, 33.34％). The complete choroidal reattachment rate at the end of follow-up was not significantly different from that observed at one month after the surgery (Chi-square test, P0.05).CONCLUSION: Transscleral suture fixation serves as a reliable technique, particularly improving the choroidal reattachment rate in the choroidal avulsion.