手术时机及方式的选择对角膜穿通伤合并外伤性白内障预后的影响(1)
[摘要] 目的 探析手术时机及方式的选择对角膜穿通伤合并外伤性白内障患者预后的影响。 方法 以本院2010年4月～2014年4月收治的70例角膜穿通伤合并外伤性白内障患者为研究对象，将患者根据手术时机及方式的不同分为两组。两组首先行角巩膜伤清创缝合术，之后，A组行Ⅰ期外伤性白内障摘除联合人工晶状体植入术，B组则行Ⅱ期外伤性白内障超声乳化联合人工晶状体植入术，比较两组术后的矫正视力情况、并发症发生率与持续时间。 结果 治疗后，两组的矫正视力≥0.8及≥0.5患者的比例比较，差异无统计学意义(P>0.05)；A组的并发症持续时间为(42.3±9.7)d，比B组长(P<0.05)，A组的并发症发生率为84.8%，高于B组的40.5%(P<0.05)。 结论 角巩膜伤清创缝合术联合Ⅱ期外伤性白内障超声乳化及人工晶状体植入术可有效恢复患者的视力，减少并发症，大幅度改善患者的预后，具有较高的临床价值。
[关键词] 手术时机；角膜穿通伤；白内障；前房
[中图分类号] R772.2 [文献标识码] A [文章编号] 1674-4721(2015)02(b)-0055-03
The influence of operation time and mode selection on the prognosis of corneal perforating injury combined with traumatic cataract
WANG Ji-ya HUA Shan HUANG He-hua ZHENG Wen-kai
Department of Ophthalmology，Donghua Hospital of Dongguan Affiliated to Sun Yat-sen University in Guangdong Province，Dongguan 523000，China
[Abstract] Objective To investigate the influence of operation time and mode selection on the prognosis of corneal perforating injury combined with traumatic cataract. Methods 70 patients with corneal perforating injury combined with traumatic cataract treated in our hospital from April 2010 to April 2014 were selected as the study objects，and they were divided into the two groups according the difference of operation time and mode.The two groups were given debridement and suturing of corneoscleral injury，then the group A was given cataract extraction combined with intraocular lens implantation in traumatic cataract of stage Ⅰ，the group was given traumatic cataract phacoemulsification and intraocular lens implantation of stage Ⅱ.Corrected visual acuity after surgery，the incidence rate and time of duration of complication in the two groups were compared. Results There was no statistical difference of the proportion of corrected visual acuity ≥0.8 and ≥0.5 of patients in the two groups (P>0.05)；the time of duration in the group A [(42.3±9.7) d] was longer than that in the group B (P<0.05)，the incidence rate of complication in the group (84.8%) was higher than that in the group B (40.5%) (P<0.05). Conclusion Debridement and suturing of corneoscleral injury combined with traumatic cataract phacoemulsification and intraocular lens implantation of stage Ⅱ can effectively restore the vision of patients，reduce the complication，and greatly improve the prognosis of patients.It has higher clinical value.
[Key words] Operation time；Corneal perforating injury；Cataract；Anterior chamber
角膜穿通伤是一种严重开放性眼外伤，伴有角膜损伤，且患者往往存在多种眼部结构及功能损害，其中外伤性白内障及晶状体损伤为最常见的并发症[1-3]。患者发生角膜穿通伤合并外伤性白内障后，合适的临床治疗对于确保患者眼部功能的恢复非常关键[4]。有临床研究认为，手术方式及时机的不同对角膜穿通伤合并外伤性白内障患者预后有不同的影响[5]。本研究对本院收治的70例角膜穿通伤合并外伤性白内障患者进行研究，探析手术时机及方式的选择对角膜穿通伤合并外伤性白内障患者预后所造成的影响。 (王继亚 华山 黄河华 郑文凯)
[关键词] 手术时机；角膜穿通伤；白内障；前房
[中图分类号] R772.2 [文献标识码] A [文章编号] 1674-4721(2015)02(b)-0055-03
The influence of operation time and mode selection on the prognosis of corneal perforating injury combined with traumatic cataract
WANG Ji-ya HUA Shan HUANG He-hua ZHENG Wen-kai
Department of Ophthalmology，Donghua Hospital of Dongguan Affiliated to Sun Yat-sen University in Guangdong Province，Dongguan 523000，China
[Abstract] Objective To investigate the influence of operation time and mode selection on the prognosis of corneal perforating injury combined with traumatic cataract. Methods 70 patients with corneal perforating injury combined with traumatic cataract treated in our hospital from April 2010 to April 2014 were selected as the study objects，and they were divided into the two groups according the difference of operation time and mode.The two groups were given debridement and suturing of corneoscleral injury，then the group A was given cataract extraction combined with intraocular lens implantation in traumatic cataract of stage Ⅰ，the group was given traumatic cataract phacoemulsification and intraocular lens implantation of stage Ⅱ.Corrected visual acuity after surgery，the incidence rate and time of duration of complication in the two groups were compared. Results There was no statistical difference of the proportion of corrected visual acuity ≥0.8 and ≥0.5 of patients in the two groups (P>0.05)；the time of duration in the group A [(42.3±9.7) d] was longer than that in the group B (P<0.05)，the incidence rate of complication in the group (84.8%) was higher than that in the group B (40.5%) (P<0.05). Conclusion Debridement and suturing of corneoscleral injury combined with traumatic cataract phacoemulsification and intraocular lens implantation of stage Ⅱ can effectively restore the vision of patients，reduce the complication，and greatly improve the prognosis of patients.It has higher clinical value.
[Key words] Operation time；Corneal perforating injury；Cataract；Anterior chamber
角膜穿通伤是一种严重开放性眼外伤，伴有角膜损伤，且患者往往存在多种眼部结构及功能损害，其中外伤性白内障及晶状体损伤为最常见的并发症[1-3]。患者发生角膜穿通伤合并外伤性白内障后，合适的临床治疗对于确保患者眼部功能的恢复非常关键[4]。有临床研究认为，手术方式及时机的不同对角膜穿通伤合并外伤性白内障患者预后有不同的影响[5]。本研究对本院收治的70例角膜穿通伤合并外伤性白内障患者进行研究，探析手术时机及方式的选择对角膜穿通伤合并外伤性白内障患者预后所造成的影响。 (王继亚 华山 黄河华 郑文凯)