The study of early vitrectomy for severe rupture of the eyeballs

Objective To study the methods of early vitreous surgery in treating severe rupture of the eyeballs,in which cornealb,roken and opacity,prolapse of eyeball content happened with anterior/posterior traumatic hemorrhage,to save the traumatic eyeballs. Methods 26 cases of complicated traumatic patients in the study were cured,by resuturing the corneal wound and using hypertonic saline to remain some transparency of the damaged cornea,by injecting some sodium hyaluronate or other viscoelastic into anterior chamber or into the vitreous cavity to raise the intraocular pressure so as to keep useful visual field for surgery,and by building safe intraocular irrigation,and then vitrectomy were carried out afterwards combining with other surgical procedures according to different posterior conditions. Results During operating,safe intraocular irrigation were built in all patients.After getting rid of the opaque corneal epithelium,three-tunnel pars plana vitrectomy were carried out via the undamaged part of the cornea.Postoperative eyeball saving rates(stable intraocular pressure and shape of the eyeballs) were 100%.3 to 6 months later,silicone oil was extracted out in 14 case(53.85%) in which the retina remained attached,and oil were still kept in 12 other eyes for safe of retinal attachment. Conclusions The secondary complicated vitreoretinal surgeries should be carried out earlier or even in the first rescuing surgery.Before the post-trauma inflammatory exudative reaction summit without corneal stromal edema or intraoculm fibrosis formation,the pathologically changed intraocular tissues were eliminated effectively,the aqueous block were relieved sufficiently,intraocular filling were done effectively as well,detached ciliary body and choroid body were reattached anatomically and functionally,the route leading to eyeball atrophy were blocked.So as to save the surviving visual function to its most extent and to provide an anatomic basis for the secondary surgery.