球内异物74例手术疗效分析

目的:分析不同的手术方法治疗眼球开放性外伤后球内异物的手术效果。方法:对74例(均为单眼受伤)开放性眼外伤合并球内异物的临床资料进行回顾性分析。结果:手术取出异物后保住眼球71眼（96%）,未保住眼球3眼（4%）。成功的71例,均完整取出异物。其中42例并发外伤性白内障(42/74,57%),18例并发玻璃体积血(18/74,24%),2例并发视网膜脱离(2/74,3%),9例继发性青光眼(9/74,12%)。其中44眼行巩膜外路电磁铁吸出异物,30眼采用玻璃体切除术取出异物。失败3例（3/74,4%）皆未完整取出异物,术后合并真菌性眼内炎而行眼球摘除术。结论:对于合并有晶状体、玻璃体混浊的眼内异物、后极部异物需行玻璃体切除术,赤道前、定位准确的磁性异物,以巩膜外路磁吸术为宜。而最终能否保住眼球和手术是否完整取出异物有一定关联。

Clinical analysis of ocular trauma and intraocular foreign bodies in 74 cases

AIM:To evaluate the effect of surgery in cases of ocular trauma and intraocular foreign bodies.METHODS:Clinical data of 74 cases with foreign bodies were retrospectively analyzed.RESULTS:Successful operation was achieved in 71 eyes(96%), 3 eyes (4%) with failed operation. In 71 cases, all foreign bodies were removed successfully. Among them the complications included traumatic cataract in 42 cases (42/74, 57%), vitreous hemorrhage in 18 cases(18/74, 24%), retinal detachment in 2 cases (2/74, 3%) and secondary glaucoma in 9 cases(9/74, 12%). 44 eyes underwent electromagnet epispastic foreign body by external-route surgery,and 30 eyes underwent vitrectomy extraction. Ophthalmectomy was carried out in 3 cases(3/74, 4%) for the fungal intraocular inflammation after the incomplete extraction of foreign bodies.CONCLUSION:Vitrectomy is more favorable for the extraction of intraocular foreign bodies and the posterior polar ones with lens turbidity and vitreous opacity. Electromagnet epispastic foreign body by external-route surgery is suitable for the accurate positioning magnetic foreign body before the equator. Ultimately the possibility whether the eye can reconstruct has certain relevance with the integrity of the foreign body’s removal.