射钉枪致眼球贯通伤的治疗体会

The experience of the treatment of penetrating injuries of eyeball caused by nail-gun

目的探讨射钉枪导致眼球贯通伤治疗效果方法对2016年1月至2017年6月共6例(6眼)射钉枪导致的眼球贯通伤的临床资料进行回顾性分析一其中前部伤口位于巩膜者3例,位于角膜者2例,位于角膜缘者1例。后部伤口均有异物(射钉)嵌顿,异物的一端突出于眼球后壁伤口之外均一期行眼内异物摘出,二期行玻璃体切除视网膜修复手术二期手术中,先行视网膜伤口部位的激光光凝,以免灌注液自视网膜伤口进入视网膜下,造成或加重视网膜脱离。结果一期手术均顺利摘出异物,二期均顺利完成玻璃体切除术。二期术后随访3~6个月,5例行硅油取出+人工晶状体植入术,1例因视网膜严重增生,未行硅油取出术。随访期末最佳矫正视力数指者1例,0.04者1例,0. 1?0.3者4例。结论射钉枪所致眼球贯通伤伤情较重,制定分期手术方案,可取得较好的临床效果。

Objective To investigate the clinical efficacy of the treatment of penetrating injuries of eyeball caused by nail-gun. Methods The clinical data of 6 eyes of 6 cases with penetrating injuries of eyeball caused by nail-gun from Jan. 2016 to Jun. 2017 were retrospctively analyzed. In 6 cases, the entrance injuiy located at the sclera in 3 cases, cornea in 2 cases and corneoscleral limbus in 1 case. The foreign body ( nail) incarcerated in the posterior injury site. One end of foreign body protruded from the posterior wall of eyeball. All cases underwent extraction of intraoc-ular foreign body at one-stage. Vitrectomy was performed at secondary stage. Photocoagulation was performed after vitrectomy. It could avoid the leakage of the perfusion fluid from the injury site, which could cause or aggravate the retinal detachment. Results The nails of 6 patients were extracted successfully without complication. After 3-6 months followup ,the silicon oil was removed and intraocular lens were implanted in 5 cases. The silicon oil of 1 case with severe proliferative vitreoretinopathy was not removed. The best corrected visual acuity was counting finger in 1 case, 0. 04 in 1 case, 0. 1 -0.3 in 4 cases. Conclusion Penetrating injury of eyeball caused by nail-gun is serious. Staging operation can obtain better clinical results.