玻璃体切除术联合激光光凝治疗眼内异物伤

目的探讨眼内异物伤应用玻璃体切除术摘出异物联合激光治疗的方法和并发症的防治。方法31例（31眼）眼内异物。其中并发外伤性白内障18例，玻璃体积血10例，严重眼内炎3例，视网膜脱离5例。眼内金属异物25例，非金属异物6例。眼内异物大小1～32mm。异物位于玻璃体腔、视网膜表面、嵌顿于眼球壁或视盘。异物均经玻璃体手术摘出。部分联合角巩膜伤口修补、浑浊晶状体摘出、环扎、气液交换，联合激光光凝、SF6、C3F8、硅油填充或植入人工晶状体。结果异物一次成功摘出30例，1例2次手术摘出。术后并发症有出血、一过性高眼压、白内障和视网膜脱离等。术后视力好转16眼，不变10眼，下降5眼。结论玻璃体切除联合激光治疗眼内异物是一种安全、准确、损伤小、成功率高、并发症少的手术．尤其是及时的应用激光治疗对于防止视网膜脱离的发生具有重要作用。

Vitrectomy combined with laser photocoagulation for treat of intraocular foreign bodies

Objective To discuss the method of vitrectomy combined with laser photocoagulation for treatment of foreign bodies. Methods 31 eye of 31 cases of intraocular foreign bodies, in which 18 cases of traumatic cataract, 10 cases of vitreous hemorrhage, 3 cases of serious endophthalmitis, 5 cases of retinal detachment, 25 cases of metallic intraocular foreign bodies, 6 cases of non - metallic foreign bodies. The size of foreign bodies was 1 mm - 32 mm. The foreign bodies were located in the vitreous cavity, retinal surface, incarcerated in the eyeball or optic papilla. All the foreign bodies were removed by vitreous surgery, some cases combined with corneoscleral wounds repairing, the opacity lens extracting, sclera buckling, airfluid exchanging, Together with laser photocoagulation, SF6, C3 F8 or siliconeoil tampanading, or intraocular lens implantation. Results The foreign bodies were removed successfully in 30 cases at the first operation, one case was taken out at the second operation. The main postoperative complications were bleeding, transient ocular hypertension, cataract and retinal detachment. The postoperative visual acuity of 16 cases were improved, 10 cases remained at the same, five cases were declined. Conclusion Vitrectomy combined with laser treatment for intraoeular foreignbody is a safe, accurate, small injury and high success ratio and fewer complications surgery. In particular, the timely application of laser treatment to prevent retinal detachment plays an important role.