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占××,女,44岁,农民.患者于1993年6月5日晨起系鞋带时,左眼撞在床脚架上,当时从眼内脱出一圆形透明物体落地,同时左眼疼痛,视力下降,并有流热泪感,随即拾起透明物就诊.既往无眼疾史.检查:视力:右眼1.0,左眼手动/20cm.左眼眼睑肿胀,球结膜充血,上方角膜缘10点到2点位可见弧形伤口,伤口处有虹膜组织及玻璃体嵌顿,角膜混浊,前房消失,前房积血达1/2,瞳孔上移,不圆,晶体缺如,眼底窥不清.查看患者带来的脱出物,呈双凸面形,光滑完整淡黄色,质软透明,正常晶体大小.诊断:1、左眼球破裂伤,晶体脱出眼外;2.左前房积血,玻璃体积血.治疗:立即在局麻下行左眼清创缝合术,术中恢复嵌顿的虹膜,剪除脱出的玻璃体,并冲洗前房积血,9—0尼龙线连续“8”字缝合角膜缘伤口,球结膜下注射庆大霉素及地塞米松.术后肌注破伤风抗毒素,应用抗生素,皮质类固醇治疗.术后8天,左眼视力:指数/50cm+小孔镜+11DS=0.4,上方角膜缘伤口愈合,可见缝线,前房积血吸收,玻璃体内可见血块及机化条索,眼底可见红色反光,细节不清.
Accounted for × ×, female, 44 years old, farmer.The patient laces on the bed on the morning of June 5, 1993, the left eye crashed into the bed tripod, at that time prolapse from the eye a round transparent object landing, while the left eye Pain, vision loss, and a sense of flow of tears, then pick up the transparent treatment. No history of eye disease. Check: visual acuity: 1.0 right eye, left eye manual / 20cm. Left eyelid swelling, conjunctival hyperemia, the upper limbus 10 Point to 2:00 visible arc wounds, wounds with iris and vitreous incarceration, corneal opacity, anterior chamber disappeared, anterior chamber hemorrhage up to 1/2, the pupil up, not round, lack of crystal, peep eyes do not see Clear view of patients with the prolapse, was double convex shape, smooth and complete pale yellow, soft and transparent, normal crystal size. Diagnosis: 1, left eyeball rupture, the lens prolapse; 2 left anterior chamber hemorrhage, glass Volume of blood treatment: immediately under local anesthesia left eye debridement and suture, intraoperative recovery incarcerated iris, cut off the prolapse vitreous, and wash the anterior chamber hemorrhage, 9-0 nylon continuous “8” suture limbal limbus Wounds, subconjunctival injection of gentamycin and dexamethasone .After intramuscular injection of tetanus antitoxin, the application of antibiotics, corticosteroids .After 8 days, the left eye as : Index / 50cm + aperture mirror + 11DS = 0.4, above the limbus wound healing, visible seams, hyphema absorption, the glass body of the machine visible and cord blood clots, visible red fundus reflex, the details unclear.