外傷性眼球破裂の治療成績

Therapeutic outcome of eyeglobe rupture by blunt trauma

要約　目的：外傷性眼球破裂症例の手術成績の報告。対象：過去7年間に治療した21例21眼を検索した。初診時の視力は全例が手動弁以下であった。初回手術として，20眼で裂創を縫合し，1眼は眼球を摘出した。硝子体出血または牽引性網膜剝離がある12眼には，初回手術から約2週間後に硝子体手術を行った。結果：最終視力は6眼（29％）が0.8以上，1眼が0.1から0.7，3眼が手動弁から0.09，5眼が光覚弁，4眼が光覚なしであり，2眼が眼球摘出を受けた。初診時に光覚がないこと，破裂創が15mmよりも大きいこと，網膜が脱出していることが，最終視力不良になる因子であった。結論：外傷性眼球破裂では適切な初期対応と積極的な治療が必要である。

Abstract.　Purpose：To report the outcome of treated cases of eyeglobe rupture. Object：This retrospective study was made on 21 eyes of 21 cases who were treated by us during the past 7 years. Initial visual acuity was hand motion or less in all the cases. As initial surgery, 20 eyes received suture of ruptured wound. Enucleation had to be performed in one eye. Vitreous surgery was performed later on 12 eyes with vitreous hemorrhage or retinal detachment. Results：The final visual acuity was 0.8 or better in 6 eyes（29％）, 0.1 to 0.7 in one eye, hand motion to 0.09 in 3 eyes, light perception in 5 eyes, and no light perception in 4 eyes. Enucleation was eventually performed on 2 eyes. Risk factors for poor visual outcome included ruptured wound of 15mm or larger, retinal prolapse and no light perception at the initial examination. Conclusion：Early and active treatment is essential to improve the visual outcome in traumatic rupture of the eyeglobe.