眼科

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复杂外伤性睫状体离断的临床特征分析 

王聪  游启生  周军  庞秀琴  史翔宇  刘毅   

  1. 100730首都医科大学附属北京同仁医院 北京同仁眼科中心 眼科学与视觉科学北京市重点实验室(王聪、周军、庞秀琴、史翔宇、刘毅);美国俄勒冈健康科学大学Casey眼科研究所(游启生)
  • 收稿日期:2018-04-19 出版日期:2018-07-25 发布日期:2018-07-27
  • 通讯作者: 刘毅,Email:liuyi513@hotmail.com

Clinical characteristics of complicated traumatic cyclodialysis

WANG Cong1, YOU Qi-sheng2, ZHOU Jun1, PANG Xiu-qin1, SHI Xiang-yu1, LIU Yi1.   

  1. 1. Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing  Key Laboratory of Ophthalmology  & Visual  Science. Beijing 100730, China; 2. Casey Eye Institute, Oregon Health Science University, Portland, OR, USA
  • Received:2018-04-19 Online:2018-07-25 Published:2018-07-27
  • Contact: LIU Yi, Email: liuyi513@hotmail.com

摘要:

 目的 探讨复杂外伤性睫状体离断的临床特征。设计 回顾性病例系列。研究对象2013年1月至2015年1月北京同仁医院就诊的复杂外伤性睫状体离断患者44例(44眼)。方法 回顾性分析患者的一般情况及临床表现特点。主要指标 性别、年龄、受伤眼别、致伤原因、视力、眼压、睫状体离断范围、眼部合并症等。结果 患者平均年龄(43±14)岁,男性39例(88.6%),右眼占52.3%。致伤原因中钝挫伤占95.5%,以铁块崩伤、爆竹崩伤和拳击伤为主。就诊时平均视力(2.3±1.1)logMAR,平均眼压(8.0±3.4)mmHg。就诊时表现低眼压者占79.6%,浅前房占31.8%。眼压与睫状体离断范围无相关性(r=-0.09, P=0.56)。平均睫状体离断范围4.8±3.2个钟点,其中16例(37%)离断范围超过180°,3例离断范围 360°。右眼颞上象限,左眼鼻上和颞上象限易发生离断。眼部其他合并症包括晶状体损伤(84.1%)、前房积血(31.8%)、房角后退(18.2%)、虹膜根部离断(34.1%)、玻璃体积血(54.5%)、视网膜脱离(31.8%)等。结论 复杂外伤性睫状体离断常合并眼部多组织损伤尤其是晶状体损伤。对眼球钝挫伤即使无浅前房、低眼压等表现也需警惕睫状体离断的可能。(眼科, 2018, 27: 301-304)

关键词:  , 睫状体离断;眼外伤;超声生物显微镜

Abstract:

Objective To analyze the clinical characteristics of complicated traumatic cyclodialysis. Design Retrospective case series. Participants 44 patients (44 eyes) with complicated traumatic cyclodialysis in Beijing Tongren Eye Center during January 2013 to January 2015. Methods Retrospective analysis of demographic and clinical characteristics of patients was performed. Main Outcome Measures Age, gender, laterality, etiology of trauma, visual acuity, intraocular pressure(IOP), range of cyclodialysis, and other trauma related complications.  Results Average age of patients was 43±14 years old. There were 39 cases (88.6%) in men and 52.3% in the right eye. The most common injury reason was blunt trauma (95.5%), mainly with iron block, firecracker and boxing. The mean visual acuity on first visit was 2.3±1.1 logMAR. The mean IOP was 8.0±3.4 mmHg. 79.6% of the patients had low intraocular pressure while 31.8% had shallow anterior chamber. The IOP was not significantly associated with the range of cyclodialysis(r=-0.09, P=0.56). The mean cyclodialysis range was 4.8±3.2 clock hours, of which 16 cases (37%) had a range of over 180 degrees, and 3 cases had a range of 360 degrees. The superior temporal quadrant of the right eye, nasal superior quadrant and superior temporal quadrant of the left eye were liable to cyclodialysis. Other  trauma-related complications included lens dislocation and cataract(84.1%), hyphema(31.8%), angle recession (18.2%), iridodialysis (34.1%), vitreous hemorrhage (54.5%), and retinal detachment (31.8%). Conclusion Traumatic cyclodialysis is usually complicated with multiple ocular tissue damage mainly with lens injury. Clinicians need to be vigilant about cyclydialysis in complicated blunt trauma even if without intraocular hypotony or shallow anterior chamber. (Ophthalmol CHN, 2018, 27: 301-304)

Key words: cyclodialysis, eye trauma, ultrasound biomicroscopy