眼球壁嵌顿异物手术时机探讨

A discussion of operative timing about foreign body in the eyeball wall.

目的 探讨经平坦部摘出眼球壁嵌顿异物联合玻璃体切除术的手术时机及其影响因素。方法 对 2 9例眼外伤球壁嵌顿异物 ,采取玻璃体切除联合异物摘出术 ,详细观察了不同手术时间的视网膜脱离 ,术中难以控制眼内出血及再发现视网膜脱离。结果 本组异物全部摘出 ,术后视力无变化及提高 2 1眼 ,视网膜平复 2 4眼。受伤后不同手术时间术中出血情况 :7天内 4眼 ,8～ 14天 1眼 ,15～ 40天 1眼 ;术前视网膜脱离 :7天内无视网膜脱离发生 ,8～ 14天 16眼视网膜脱离 ,15～ 40天 3眼视网膜脱离。结论 眼球壁嵌顿异物的最佳手术时机为伤后 10天左右 ,7天内手术易发生术中难以控制眼内出血 。

Objective To study the operative timing and the factor of influcence for the extraction of the foreign body in the eyeball wall combined with the vitrectomy through pars plana.Methods 29 cases foreign body in the eyeball wall underwent vitrectomy with foreignbody extraction and observed carefully the retinal detachment in different operative time.Uncontrolled intraocular hemorrhage during the operation and the recurrent of retinal detachment.Results All the foreign bodies in the eyeball wall were extracted.Postopenative vision were unchanged or improved in 21 eyes.The retinal of 24 eyes were reattached.The operative time were 4 eyes within 7 days,1 eye in 8～14 days and 1 eye in 15～40 days.There was no one preoperative retinal detachment within 7 days and there were 16 eyes in 8 days,3 eyes in 15～40 days.Conclusion The best operative timing of the foreign body in the eyeball wall is about 10 days after ocular trauma.The operation will result in uncontrolled intraocular hemorrhage within 7 days.Preoperative retinal detachment will obviously observed after 15 days.