玻璃体切除联合眼内异物取出术后锯齿缘截离的临床分析

Clinical analysis of ora serrata dialysis after extraction of intraocular foreign boby during vitrectomy

目的 :探讨经睫状体平坦部玻璃体切除联合眼内异物取出术后发生锯齿缘截离的危险因素及其预防措施。方法 :对 130例经睫状体平坦部玻璃体切除联合眼内异物取出术后发生锯齿缘截离的 15例进行回顾性统计分析。结果 :发现异物大小、性质、眼内位置、出入口位置、取出方法、术中行巩膜环扎与否与锯齿缘截离发生无关 ,术前合并化脓性眼内炎、术后玻璃体视网膜情况差与锯齿缘截离发生有关。 15例锯齿缘截离经手术治疗后 ,有 12例视网膜平伏 ,2例术中因视网膜情况差未能复位 ,1例拒绝手术。结论 :术前合并化脓性眼内炎者 ,应及早手术治疗。在经睫状体平坦部玻璃体切除联合眼内异物取出术中 ,应彻底切除玻璃体基底部 ,防止术后前段增殖性玻璃体视网膜病变的发生而导致锯齿缘截离。一旦发现锯齿缘截离 ,尽早手术 。

Purpose:To evaluate the risk factors and precautionary measures of ora serrata dialysis after extraction of intraocular foreign boby (IOFB)during vitrectomy.Methods:15 cases of ora serrata dialysis after extraction of IOFB(130 cases)during vitrectomy were analyzed retraspectively.Results:Ora serrata dialysis was related to IOFBs size,magnetism,location,entry site,extractions methods and site,scleral buckling.However,it was related to conditions of postoperative vitreous and retina as well as combined with preoperative endophthalmitis.Conclusion:If these patients combined with preoperative endophthalmitis,they should be operated as soon as possible.During the operation,we should cut vitreous completely to prevent anterior proliferative vitreoretinopathy(aPVR)which might lead to ora serrata dialysis.