眶内异物的临床分析及治疗策略探讨

Clinical analysis and investigation on diagnosis and the tactics of treatment of orbital foreign body

目的：分析和探讨眶内异物的诊断、治疗方法及策略。方法对我院2009年1月至2014年12月收治的眶内异物42例（46眼）进行回顾性分析。结果15眼未行异物摘出,随访期内无视力下降或眼球运动障碍,31眼行异物摘出术。本组病例并发症有：视网膜脱离、角膜白斑、上睑下垂、眼球运动障碍及复视等。结论眶内小的金属异物多被组织包裹,可以在眶内存留,不必勉强摘出；较大的异物、位于眼外肌附近或眶前段异物及植物性异物应行手术摘出；眶尖部、视神经处异物应小心摘出；表面光滑、对视力、眼球运动无影响,未引起感染的较小异物不必手术摘出。

Objective To investigate the clinical features, diagnosis, tactics of treatment and complications of the orbital foreign body. Methods A retrospective analysis of forty-six eyes of forty-two cases with orbital foreign body in our hospital from Jan. 2009 to Dec. 2014 was carried out. Results Fifteen eyes did not receive foreign body extraction, and no vision decrease or eye movement disorders happened. Thirty-one eyes received foreign body removal. The complications included retinal detachment, corneal leukoma, ptosis, eye movement disorder and diplopia. Conclusion The small metal foreign body in orbit encapsulated by orbital tissue does not need to be extracted. Large foreign body that located near the extraocular muscles, or in the anterior part of orbit, and vegetal foreign body, should be treated by surgical removal. Foreign body at the orbital apex or near optic nerve should be carefully removed. Minor foreign body with smooth surface, which has no effect on visual acuity or eye movements, is not necessary for surgery.