玻璃体切除术摘出眼内异物的临床探讨

Clinical study ofvitrectomy for removing intraocular foreign bodies

目的 探讨玻璃体切除术摘出眼内异物的手术时机和手术方法.方法 从2005年1月至2007年12月用玻璃体切除术摘出眼内异物的70例（71只眼）患者的临床资料进行回顾性分析.结果 71l眼中69只眼经玻璃体手术摘出异物,成功率97.18%.1只眼因术后发牛新生血管性青光眼摘除眼球,其余70跟眼球得以保存.术后视力改善48只服（67.61%）,无变化11只眼（15.49%）,视力下降12只眼（16.90%）.术后发生视网膜脱离9只眼;继发性青光眼3只眼;眼内炎1只眼;硅油从贯通伤后巩膜伤口漏出至结膜下1只眼.结论 玻璃体切除术具有在直视下摘出眼内异物,提高手术成功率,同时处理伴随病变,为视功能恢复创造条件等优点,应尽早手术摘出眼内异物.早期手术和术中恰当的处理是取得较好疗效的关键.

Objective To discuss the timing and methods of vitrectomy for removing intraocular foreign body （IOFB）.Methods Seventy cases （71 eyes） vitrectomy associating with removing IOFB were analyzed retrospectively.Results IOFB was removed by vitrectomy in 69 eyes, the success rate was 97.18%.After operation vision of 48 eyes （67.61% ） were improved, 11 eyes（ 15.49% ） not changed, eyesight of 12 eyes （16.90%） declined.Seventy eyes were saved except that 1 eye was enucleated for neovascular glaucoma.Postoperative complications included retinal detachment in 9 eyes, secondary glaucoma in 3 eyes, endophthalmitis in 1 eye, subconjunctival silicone oil for posterior sclerat wound leakage in 1 eye.Conclnsions Vitrectomy can be used to remove IOFB under directly inspection and the accompanying complications can be resolved at the same time.It sets the stage for visual rehabilitation.IOFB should be removed as immediate as possible.Early surgical intervention and appropriate methods are the critical factors to achieve good results.