鈍的外傷による眼球破裂の手術治療

Surgical outcome of eyeglobe rupture by blunt trauma

　過去8年余の期間に治療した，鈍的外傷による眼球破裂18眼の転帰を検討した。全例が片眼性であり，初診時の視力は手動弁以下であった。受診直後に，眼球摘出を5眼（28％），破裂創の縫合を13眼（72％）に行った。創縫合を行った13例中4眼（22％）には術直後に光覚がなく，眼球癆となった。8眼では創傷縫合から約2週後に硝子体手術を行い，他の1眼は手術を拒否した。硝子体手術を行った8眼すべてに，以後6か目以上の期間，網膜剥離は発症しなかった。18眼での最終視力は，O．O1以上が6眼（33％），0.1以上が3眼（17％）であった。

We reviewed the outcome of surgically treated 18 eyes of eyeglobe rupture caused by blunt trauma during the past 8 years. All the cases were unilaterally involved. The initial visual acuity was less than hand motion in all the cases. The affected eye was immediately enucleated in 5 cases (28%) . The open wound was closed by suture in the other 13 eyes (72%). Out of these 13 eyes, 4 eyes (22%) had no light perception after surgery and resulted in phthisis bulbi. Eight eyes underwent vitreous surgery about 2 weeks after wound closure. One case refused further treatment. No retinal detachment developed in all the 8 eyes treated by vitrectomy during the ensuing 6 months. The final visual acuity in the 18 eyes was 0.01 or over in 6 eyes (33%) and 0.1 or over in 3 eyes (17%) .