Objective To investigate the causes of failure of the primary vitrectomy,sum up the experience for secondary vitreous surgery and improve the success rate of primary vitrectomy for complicated retinal detachment． Methods The records of a consecutive series of 60 patients(65 eyes)that underwent secondary vitreous surgery between 1997 to 1998 were retrospectively reviewed.The age of patient ranged from 9 to 63 years(mean 36),and the followup period ranged from 3 to 18 months(mean 10.5 months). Results The main causes of failure of the primary vitrectomy were postoperative recurrence of proliferative vitreoretinopathy(PVR),unwell closed retinal breaks,and intra-and postoperative complications.In 46 of 65 eyes the retina was reattached after secondary vitreous surgery(70．1%)．Postoperatively,31 eyes (47.7%) had a visual acuity(VA)improved,16 eyes(24.6%)had a VA unchanged,and 18eyes(27.7%)had a VA reduced．Fifteen eyes(23.1%)had a VA of ge;0.05 and the best VA was 0.4．Thirty-nine eyes were followed-up from 3 to 18 months(mean 10.5)．In 35 of 39 eyes,the retina was reattached(89.7%),26 eyes(40%)had a VA of ge;0.05,and 7 eyes(10.7%)were hypotonic. Conclusions The keys to the success of secondary vitreous surgery are to restore the mobility for retina by eliminating the PVR completely,and avoid intraoperative complicattions by choosing the appropriate closure procedure for retinal breaks and the suitable intraocular tamponades. (Chin J Ocul Fundus Dis,20000,16:24-26)
Purpose To evaluate the efficacy of vitreous surgery for treatment of fundus damages caused by ocular blunt trauma. Methods Clinical records were reviewed retrospectively for a series of consecutive 101 patients (105 eyes) with fundus damages caused by ocular blunt trauma underwent vitreous surgery from October 1992 to March 1998． Results Based on clinical examination and findings during surgery,all cases were divided into 4 subgroups:vitreous hemorrhage(VH)in 23 yes,VH with retinochoroidal rupture or optic damage in 25 eyes,traumatic retinal detachment in 46 eyes,and retinal giant tear in 11 eyes.Vision acuity improvement achieved in 77 eyes(73.3%)and of them 69 eyes(65．7%)had 0.02～0．6with 38 eyes(55．0%)better than 0．1.Two eye s with no light perception obtained better than 0.1． Visual acuity remained unchanged in 26 eyes(24.8%)and 2 eyes(1.9%)became worse after operation．The retina reattached in 54 eyes(94.7%). Conclusion Severe ocular blunt trauma may cause visual impairment and various fundus damages.Appropriate vitreous surgery can salvage most eyes with those injuries. (Chin J Ocul Fundus Dis,1999,15:100-102)
目的：分析地震灾害中颅脑外伤合并眼伤的临床特点和诊治难点，为制定合理的对策提供参考。方法：统计分析2008年5月12日汶川地震中绵阳地区颅脑外伤合并眼伤96例的疾病资料，以及早期处理方案和效果。结果：颅脑外伤合并的眼伤中钝挫伤比例高(99.5%)，昏迷患者容易忽视眼部损伤。结论：在生命抢救后的功能抢救阶段及时检查眼部情况有利于早期发现和挽救视功能；根据灾情整合眼科医疗资源，利用原有团队建制，有利于提高医院对大规模灾情的紧急应对效率。
Ocular trauma is the most common cause of monocular vision loss in children. Among the patients with eye trauma in China, 15%-20% are children. The complexity of diagnosis and treatment and the uncertainty of prognosis are high because the ocular tissue of children is not fully developed and the history collection and examination are difficult. In order to further standardize the treatment of children's eye trauma and improve the treatment level, Ophthalmology Group, Ophthalmology Society, Chinese Medical Association has formulated Expert consensus of the treatment of pediatric ocular trauma in China by combining domestic and foreign literature and the actual medical situation in China. This consensus provides detailed recommendations on the classification, cause of injury, history collection, examination methods, diagnosis and treatment principles of pediatric eye trauma. This consensus applies to Chinese ophthalmologists and medical personnel engaged in the treatment of children's eye trauma, aiming to provide scientific guidance for the diagnosis and treatment of children's eye trauma, assist clinical decision-making, and further improve the treatment level of children's eye trauma in China.
Emergency treatment of ocular trauma is a systematic and complicated work. Rapid and correct diagnosis and treatment are needed to maximize the recovery of ocular structure and function. In recent years, China has made remarkable progress in the emergency treatment of eye trauma, including the development of Expert consensus on the norms of emergency treatment of eye trauma in China (2019), the establishment of a national ocular trauma database, and the development of VisionGo artificial Intelligence prediction system for eye trauma. These measures improve the treatment level of ocular trauma and provide support for the prediction of postoperative visual acuity in severely dull eyes. However, with the development of economy and society, the characteristics of ocular trauma in our country have changed. For example, the majority of hospitalized patients were open eye injuries, farmers and workers were the main occupational groups, and the proportion of eye injuries caused by traffic injuries increased year by year, and the proportion of women and minors increased. Although the annual loss of life of eye trauma disability in China has decreased faster than the world average, the emergency treatment of eye trauma still faces many challenges, such as regional differences, insufficient primary medical resources, lack of standardized training, and insufficient promotion of emergency treatment standards. In order to cope with these challenges, it is necessary to further strengthen the popularization of science and technology for the prevention and treatment of eye trauma, standardize the emergency treatment process, strengthen the training of grass-roots medical personnel, strengthen the safety of emergency surgery, and pay special attention to the particularity of children's ocular trauma. In addition, relevant research has been actively carried out to establish a complete database of emergency patients with eye trauma to promote the accurate prevention and treatment of ocular trauma.