Vitrectomy Applicate In Complicated Ocular Injury And The Analysis Of Operation Complication

Human eye is important, but it is only exposed to the surface and the organizational structure of the fragile and delicate organ. It vulnerable to injury resulting in loss of visual impairment or even loss of the eyeball. In their daily lives, nearly 90% of ocular trauma occurred in the early childhood years, young adults, therefore, timely and correct handling of ocular trauma is particularly important. Ocular injuries with no clear-cut diagnostic criteria, the paper referred to the complexity of ocular trauma involving mainly refers to the eye before and after the paragraph, often combined intraocular foreign body, eye hemorrhage, lens or retinal damage from the injury and the eye injury, the extent of serious , complex, if not treated in time, will eventually lead to the eyeball and even the loss of eyeball atrophy is a common ophthalmic one of the main causes vision loss. Since the 70s of last century, the United States, Dr. Machemer applications by the beginning of the ciliary body pars plana vitrectomy, the field of vitreoretinal surgery has brought the rapid development of ophthalmology in the history of a revolution in the treatment of many incurable diseases have been considered of eye disease was a more effective treatment. In particular the rise of the 80's and the pathophysiology of traumatic as well as the development of vitreous surgery, making the complexity of the prognosis of ocular trauma has improved significantly, many of the past can not be treated eye injuries was the opportunity to sight. Vitrectomy has the following advantages:①to cut vitreous under direct vision, intraocular foreign bodies removed, accuracy, and high rate of foreign body removed, greatly reducing the incidence of complications of ocular trauma;②vitreous diseases can be fully removed, free of foreign body, removed to avoid when such organizations as retinal traction and reduce the occurrence of retinal detachment;③expanded the indications for surgery, so that over the past difficult to remove the non-magnetic foreign bodies, local and foreign film wrapped, multiple foreign body, a small foreign body can be removed; resectability of lens opacity, vitreous body, improve eyesight, to prevent proliferative vitreoretinopathy (PVR) formation;④can be injected into the eyes of different fillings, so flattening the retina and restore intraocular pressure and reduce the occurrence of retinal detachment. Now in our hospital from January 2004 to December 2008 Such as the use of vitrectomy in treatment of 58 cases (60) the complexity of the treatment results of ocular trauma reported as follows:Objective: To investigate the treatment of complicated vitrectomy in ocular trauma effect, affecting factors and complications.Methods: from January 2004 to December 2008 admitted to the complexity of 58 cases of ocular trauma in 60 patients with routine pars plana ciliary body three-channel closed vitrectomy combined with cataract extraction and intraocular lens implantation, intraocular foreign body removed techniques, such as retinal reattachment surgery, its efficacy, the impact of factors and complications were analyzed retrospectively.The results of surgical treatment of the standard: According to Ryan, and A llen standards, the treatment effect will be divided into:①functional recovery: visual acuity was improved 2 lines or more, or preoperative visual acuity light perception, visual acuity increased to more than 0.02.②anatomical recovery: stromal refractive transparent, retinal eye reconstruction successful anatomic reduction, and visual acuity less than the above standard or substandard infant visual inspection authors.③unless these: post-operative visual acuity did not improve or get worse, and refractive stromal opacities still, or the structure of the reconstruction of the failure of the eyeball and the eyeball atrophy. Discharge, functional recovery 30, 22 anatomical recovery, unless these eight. The cure rate was 86.67%. Preoperative visual acuity compared with 43 cases improve, the same 12 cases, five cases of decline. Preoperative and postoperative visual acuity in the table below for details. Follow-up: patients were followed up for 4 ~ 20 months (average 14 months) 58 patients, no lens-corrected visual acuity of≥0.3 on the 7 line after 3 months 2 intraocular lens implantation; have crystal eyes of 5 eyes, postoperative cataract, the phacoemulsification or extracapsular extraction combined intraocular lens implantation. The 12 patients were postoperative visual acuity≥0.3, the best visual acuity of 0.8. Follow-up at the end of times, the recovered 52 (86.67%), vision≤0.02 were 26 (43.33%), vision> 0.02 34 (56.67%), in which visual acuity≥0.1 were 18 (52.94%), best corrected visual acuity 0.8. Unless these occur in the eye to shrink 8. Postoperative bleeding complications after vitrectomy in 16 eyes turbidity, the absorption of drug therapy with 12 eyes. Retinal detachment in six eyes (two eyes recurrence), four eyes again after vitrectomy, retina was reattached good, but vision in 0.08 below, two eyes to give up treatment. 5 eye endophthalmitis in one eye can not control, but control is only four light perception visual acuity. 10 follow-up eye eyes appear to shrink, and accompanied by severe endophthalmitis or retinal detachment or PVR.Conclusion:1 vitrectomy is to deal with the complexity of the best way to ocular trauma, in addition, can also be combined with intraocular lens implantation, scleral condensation pressure techniques, or silicone oil filled with an inert gas, perfluorocarbons, intraocular electrocoagulation, corneal transplant surgery, the eye will greatly improve the success rate of surgical trauma.2 we emphasize the importance of serious eye injury should be the micro-processing stageⅠ. In addition to some serious rupture, "light perception" eye or eye eyeball atrophy early after trauma patients who do not easily decided to remove the eyeball. Sometimes by careful microsurgical suture line and in a timely manner all vitreous surgery to restore vision to make it.3 how to improve surgical techniques, to avoid or reduce the occurrence of complications and still correctly handle the complications is to improve the efficacy of vitreoretinal surgery the key to the future is to be further addressed.