眼内巨大异物玻璃体切除联合巩膜L形切口摘出术

Vitrectomy combined with L-shaped scleral incision for extraction of large intraocular foreign body

目的探讨玻璃体切除手术中眼内巨大异物摘出的手术方法。方法回顾性分析32例（32眼）眼内巨大异物（≥5mm）玻璃体切除联合巩膜L形切口摘出手术病例资料，观察手术效果及手术并发症情况。结果所有患者均顺利摘出异物，并完成玻璃体视网膜手术，18眼行C3F8充填，14眼行硅油充填。随访3～12个月，视力提高者28眼（87．50％），视力未提高者4眼（12．05％）。影响视力的主要因素是角膜瘢痕、角膜散光及后极部外伤性视网膜病变。未发生因异物摘出过程中或手术切口造成的手术并发症。结论通过巩膜L形切口能够顺利摘出眼内巨大异物，手术方法简便，术后并发症少，是较好的手术方法。

Objective To investigate the better way during the vitrectomy for extraction of large intraocular foreign body （IOFB）. Methods The clinical data of 32 eyes of 32 patients who received vitrectomy combined with L-shaped scleral incision for large IOFB extraction were analyzed and the surgical effects and complications were observed. Results The IOFBs were successfully extracted from all patients, and the vitreoretinal surgeries were all completed. Among them, 18 eyes were tamponed with C3Fs, and 14 eyes with silicone oil. After 3-12 months follow-up, the vision improved in 28 eyes （87.50%） and didn＇t improve in 4 eyes （ 12.50% ）. The main factors affecting the vision were corneal scar, corneal astigmatism and traumatic retinopathy in posterior pole. No complications occurred due to IOFB removal and the L- shaped incision. Conclusion L-shaped scleral incision can be successfully used for large IOFB extraction. The surgery is simple with fewer complications and is a better surgical method.