粘弹剂在不同眼球破裂伤手术中的应用

目的：分析粘弹剂在不同眼球破裂伤手术中的有效作用。方法：回顾并分析27例不同程度眼球破裂伤患者的治疗，其中包括复杂角膜裂口并虹膜脱出修复术、摘出前房异物、瞳孔区非磁性异物、虹膜根部断离，晶体损伤或脱位等。术中应用粘弹剂固定异物、充填前房及玻璃体腔。观察术后6个月的眼球形态、视力等指标。结果：术后观察最少6个月。27例眼球全部保留，24例有视力。3例因继发视网膜脱离复住2次手术失败而失明，后眼球萎缩，植入义眼。11例白内障现代囊外摘除或PHACO术后植入人工晶体，3例晶体脱位者摘除晶体后缝线植入人工晶体。11眼视力在0．5以上。无眼内炎及交感性眼炎发生。单纯前节手术10人中均有术后轻度眼压增高，但很快恢复正常。3例因伴有视网膜脱离患者术后眼压低，术后失明。结论：不同重度眼外伤后眼内容大量丢失。眼球形态政变。应用粘弹刑可为手术提供方便，也能为保全眼球并恢复视能提供机会。在前房异物取出时能有效固定异物，为异物的取出创造是好的基础。

Application of Hyaluronan in operations of different lacerated Wounds of the Eyeball

Objective: To evaluate the effect of Hyaluonan in operations of different lacerated wounds of eyeball. Methods: During the operations,hyaluonan was used to fix foreign body and fill anterior chamber and cavity of vitreous body. The morphology of eyeball and vision were observed six months after operation. Results: After operation, eyeballs of 27 cases were all reserved, in which, 24 cases had vision; 3 had ablepsia because of unsuccessful operations; 11 underwent extracapsular cataract extraction or were embedded artificial lens after PHACO operation; vision of 11 cases reached above 0.5. There were no intra-ocular inflammation and sympathetic ophthalmia in the postoperative patients. Conclusion: Different degrees of eye trauma resulted in loss of contents in the eyes as well as the change of morphology of eyeballs. Applying hyaluronan would facilitate the operation and offer opportunities for saving the eyeballs and recovering the vision of the patients.