经巩膜隧道切口眼前段异物取出术

目的:探讨经巩膜隧道切口眼前段异物取出术的效果。方法:眼前段异物8例8眼经3∶00或9∶00角膜缘辅助切口,前房注入粘弹剂,游离异物至瞳孔区后经12∶00巩膜隧道切口以玻璃体异物钳取出异物。2例同时行超声乳化人工晶状体植入。结果:8例8眼经巩膜隧道切口1次顺利取出异物,无1例发生医源性损伤或手术并发症。术后视力提高6眼,不变2眼。结论:经12∶00巩膜隧道切口联合角膜缘辅助切口可有效取出任何钟点位眼前段异物,较常规角巩缘切口手术方法以更小切口,更小损伤取出异物。     

危及晶状体的穿透性深层角膜异物取出

目的:探讨危及晶状体的穿透性深层角膜异物取出方法。方法:本次观察中共有患者12例12眼,其中植物性11眼,金属性1眼,均为位于瞳孔区的穿透性深层角膜异物。患者术前30min予全身镇静药,缩瞳剂充分缩瞳,以15°角膜穿刺刀作前房穿刺,确保无房水外漏,粘弹剂自穿刺口注入前房并加深其深度,以无齿镊挟持异物将其顶退出角膜表面,另手以有齿镊接应将异物拔除,或将异物拨向虹膜面并将其拽入前房,经角膜切口取出。结果:12眼异物均顺利取出,1眼多发性异物因初始取出经验不足导致术后轻度并发性白内障,8眼有角膜渗漏(其中3眼行角膜缝合),经加压包扎后恢复。结论:对于危及晶状体的穿透性深层角膜异物,术前应设计一个有针对性的周详应对方案,在外路取出存在危险的情况下,内路取出法不失为一个理想的方法。     

眼前段栗刺异物伤临床分析

目的探讨眼前段栗刺异物伤的临床特点、治疗方法及其临床效果。方法对128例（140眼）眼前段栗刺异物伤进行回顾性分析。根据眼前段栗刺异物的不同位置和不同的存留时间而采取角膜深层异物剔除术、角膜或巩膜切开异物摘出术、黏弹剂前房注射静态抽吸法前房异物摘出术、晶状体超声乳化吸出人工晶状体植入联合异物摘出术以及虹膜恢复器顶压异物法。结果140眼眼前段异物全部成功地摘出。91眼（65．00％）术后视力不同程度提高。视力保持不变者49眼（35．00％）。无视力下降者。结论栗刺所致的眼前段异物易引起严重感染，采取恰当的方法彻底清除异物是治疗成功的关键。     

多发性角膜深层异物取出临床观察

目的:探讨多发性角膜深层异物取出方法。方法:本组患者42例45眼,其中异物穿透角膜全层并部分伸入前房者13例。磁性异物2例,非磁性异物36例,混合性异物4例。未穿透角膜者可用显微镊直接拔出,或作一浅层角膜切开后拔出。穿透角膜者,充分缩瞳,以15°角膜穿刺刀作前房穿刺,确保无房水外漏,黏弹剂自穿刺口注入前房并加深其深度,以顶退的方式自角膜面将异物稍加送出,露出异物尾端,此时不急以拔除,而以相同的手法处理其余异物,待所有异物尾端均露出角膜面后,再以多个有齿镊同时将异物取出。结果:45眼异物42眼顺利取出,3眼因初始取出经验不足导致术后并发性白内障,8眼合并虹膜炎,10眼发生角膜炎均为伤后超过1wk方来就诊者。在伤后3d内及时就诊的患者,术后视力改善几率明显高于1wk者。结论:对于多发性深层角膜异物,尤其是多发性穿透性角膜异物的取出,应争取尽早就诊手术,手术设计应以保护晶状体为前提,尽量减少手术并发症的发生。     

眼外伤后中心性浆液性脉络膜视网膜病变一例

患者男，33岁，工人。因“右眼铁屑崩伤视物不清半小时”于2004年7月23日以“右眼球内磁性异物”入院。入院时查体：右眼视力0．2，眼压T2，角膜缘7点位有1长约5mm纵向全层裂口，有少量玻璃体嵌顿，角膜透明。前房稍浅，前房下方Ⅰ级积血。瞳孔圆。晶状体透明在位，眼底未查。左眼视力1．0，眼前段及眼底未见异常，眼眶CT示：右眼内金属异物，     

粘弹剂在眼前段穿孔伤修复术中的应用

本文报告在17例眼前段穿孔伤初期修复手术中应用粘弹剂的效果和经验。粘弹剂有利于前房的形成和保持,便于进行角膜伤口的缝合和处理并发症。介绍了虹膜嵌顿、前房出血、虹膜根部离断、晶体破裂、玻璃体脱入前房等的处理方法。     

玻璃酸钠驱逐法摘出眼前段非磁性异物

目的 探讨眼前段非磁性异物摘出的方法。方法 在异物周围，尤其是在异物后方注射一定量玻璃酸钠，凭借玻璃酸钠对异物娩出通道的软性扩张作用和对异物的软弹性推力，将异物逐出眼球。结果 本组27例(28眼)眼前段非磁性异物被全部安全快捷地摘出，无一发生手术误伤或手术并发症。结论 该手术方法对摘出眼前段非磁性异物非常有用，对取出眼前段磁性异物也有一定的借鉴意义。     

手术显微镜下取深层角膜异物

深层角膜异物临床上不少见，取出有一定难度。现将我们在手术显微镜下取出15例报告如下。一般资料：深层角膜异物15例，全部男性，年龄17－52岁，平均30±3．7岁，均为门诊病例。磁性异物10例，非磁性异物5例，其中玻璃异物2例。13例为朋击伤异物，2例为打碎眼镜时碎玻璃片进入角膜深层。除2例异物尖部已部分进入前房外，余均为角膜层间异物，末端均在角膜间质层内。（末端仍露出角膜表面，因取出较易，我们未列人本组深层角膜异物内）。异物一般均小于1．0×1．0×1．0mm3，但也有长径大于1．0mm的，系斜嵌在角膜深层或已部分突入前房者。…     

角膜穿孔伤缝合联合白内障摘出Ⅰ期后房型人工晶状体植入术临床观察

我们自1991年3月至1998年1月施行了52例角膜裂伤缝合联合白内障摘出并Ⅰ期后房型人工晶状体植入术，效果较满意，报告如下。一般资料：本组52例中，男36例，女16例，平均年龄36．5岁。受伤原因：硬物碎片弹起击伤、钢筋或铁丝弹伤、钉、铅笔刀及木棍扎伤、爆炸伤、碎屑击伤等。合并虹膜嵌顿对眼，虹膜粘连18眼，前房租血8眼，前段异物3眼，角膜伤口长4－6mm不等，所有病例均伴晶状体前囊裂伤，部分病例皮质溢入前房。受伤距手术时间3小时至7天，术前经眼部彩超及CT检查均无玻璃体出血、后段损伤、后段限内异物及眼内炎表现。术后均随访3月…     

前房残留全氟化碳液临床分析

目的：探讨全氟化碳液前房内残留的临床表现、预后及引起角膜损害的原因。方法：分析7例行全氟化碳液辅助的玻璃体视网膜手术手前房内全氟化碳液残留的病例。其中裂孔性视网膜脱离5眼，外伤性视网膜脱离2眼。结果：全部7眼中左右眼出现了角膜水肿，经取出后角膜全部恢复透明，其中1眼远期有角膜深层新生血管形成，4眼角膜及前房无异常反应。结论：全氟化碳液残留于前房易引起角膜毒害，术后应有时取出，防止引起更严重的并发症。     

Clinical Efficacy of Surgical Removal of Deep Corneal Plant Foreign Bodies

 PURPOSE:To describe a technique for removing deep corneal plant foreign bodies. METHODS:Twelve patients (7 males and 5 females, aged 5 to 56 years) with plant foreign bodies embedded in the deep cornea were treated between July 2011 and December 2012. The course of disease ranged from 1 to 11 d. Four of the patients had wooden foreign bodies, 3 had bamboo foreign bodies, and 5 had flower thorns; all underwent surgical removal. During the surgery, a novel suture needle was used to remove the foreign bodies. For injuries with a deep tunnel caused by the foreign bodies, the tunnel was cut open with a keratome. The foreign bodies were then removed and necrotic tissue was thoroughly debrided. Incisions were closed with interrupted sustures. The corneal foreign bodies were collected postoperatively for fungus and bacterial culture and appropriatemedical treatment was provided. RESULTS:Bacteria were identified in 3 cases, fungus in 3 cases, and no bacteria or fungus in 6 cases. All corneal foreign bodies were embedded deep in the corneal stroma without incidence offull-thickness corneal penetration or intraocular infection. CONCLUSION:Plant foreign bodies embedded in the deep cornea should be removed immediately. During the surgery, the foreign bodies and surrounding necrotic corneal stroma should be completely removed. The injured cornea should be cut open to eliminate necrotic tissues when necessary.     

眼前段微小异物UBM定位及异物摘出联合手术

目的：探讨眼前段微小异物的超声生物显微镜（UBM）定位的意义及异物摘出联合白内障摘出等手术的效果，方法：应用其他检查方法未能确定的12例眼前段微小异物，同时合并铁质沉着症，通过UBM检查，明确异物位置并采取异物摘出联合白内障囊外摘出，玻璃体切除，晶状体切除和／或人工晶状体植入手术。结果：12眼均顺利摘出异物，同期植入人工晶状体9眼中的8眼获得0．5以上良好视力，结论：高度怀疑眼前段微小异物，UBM检查是一种极好的定位方法：联合手术可使视力迅速恢复。     

Removal of corneal foreign bodies that project into the anterior chamber: use of a suture needle

PURPOSE: To describe and illustrate a simple and reliable technique for removing penetrating corneal foreign bodies. METHODS: A 6-mm needle was placed through the cornea beneath the corneal foreign body to provide support and illumination posteriorly. RESULTS: In eight eyes of eight patients all penetrating corneal foreign bodies were removed completely without severe complications. CONCLUSIONS: The use of a suture needle during removal of penetrating corneal foreign bodies is simple, effective, reliable, and inexpensive.     

直视下前段玻璃体腔磁性异物简易取出术的疗效观察

目的：探讨外伤性白内障合并前段玻璃体腔磁性异物伤的简易手术方法及其疗效观察。 方法：术前评估13例眼球异物穿通伤,对外伤性白内障后囊穿破合并前段玻璃体腔磁性异物的病例作改良手术方法,伤眼行白内障抽吸及清除脱出的玻璃体后,在双目间接检眼镜直视下经角巩缘切口用稀土磁棒将玻璃体腔磁性异物取出,观察术后眼内情况及视功能恢复情况。 结果：患眼13例均于直视下成功取出异物,手术过程快捷顺利,未出现继发出血或感染等并发症,矫正视力均有较大程度的提高。随诊6 mo矫正视力〉0.3者10例,0.1～0.3者3例。 结论：在双目间接检眼镜直视下进行异物定位,使用眼内稀土磁棒准确磁吸取出异物,操作简单安全,是一个可靠的手术方式选择。     

眼内异物46例疗效回顾分析

目的：回顾性分析不同性质、部位的眼内异物的不同手术方法及预后。
　　方法：对我院2010-06/2013-04住院治疗的眼内异物患者46例46眼的临床资料进行回顾性分析。
　　结果：前段异物直接切开取出或磁吸取出;后段定位准确的磁性浅表异物行眼内异物磁吸术,非磁性及视网膜异物行玻璃体切除术,手术成功并完整取出异物。保留眼球形态46例(100%),达到功能治愈者33例(72%),解剖治愈12例(26%),未愈1例(2%)。
　　结论：手术旨在重建眼球结构,保留其完整性,尽可能保存及恢复视功能。根据异物性质及眼球损伤情况选择合适的手术方式及时机将很大程度的影响预后,减少并发症发生,有效保全眼球及保留或提高视功能。     

Removal of semitranslucent cactus spines embedded in deep cornea with the aid of a fiberoptic illuminator

PURPOSE: To report a rare case of multiple cactus spines embedded deep in the cornea that were removed with the aid of a fiberoptic illuminator. DESIGN: Interventional case report. METHODS: A 20-year-old man had an accidental ocular injury of the right eye when he hit a household miniature cactus plant. There were 80 to 90 spiculated foreign bodies embedded in the cornea, some of them even penetrating the anterior chamber. RESULTS: Removal of the foreign bodies was performed with the aid of a fiberoptic illuminator, which was chosen because it provides superior visualization of the semitranslucent spines. No residual corneal spines were found postoperatively. CONCLUSIONS: Household miniature cactus plants can cause corneal injury, with multiple foreign bodies that can be difficult to localize and remove. The use of a fiberoptic illuminator in such a situation is simple and effective.