不同方式摘出后段眼内异物的临床效果比较

Comparison of clinical effect of different methods of posterior intraocular foreign body extraction

目的观察采用不同方式摘除后段玻璃体内异物的临床疗效。方法采用回顾性病例对照研究,以某院眼科2016年3月-2018年3月接收诊治的48例玻璃体内磁性异物患者作为研究对象,分为对照组和试验组,每组24例(24只眼)。对照组采用巩膜外路磁吸术处理,试验组则实施玻璃体切除异物取出术,手术结束后分别观察和统计两组患者的眼内异物取出一般结果、视力恢复及并发症情况。结果试验组患者眼内异物摘除成功率为100.0%,对照组则为83.3%,试验组的手术时间和住院时间均明显低于对照组(P<0.05)。术后3个月进行最佳矫正视力检查,手动、指数、0.05~0.1、0.2~0.4、0.5以上视力者试验组分别为1、1、2、11、9只眼,视力较术前明显好转;对照组则分别为2、6、3、8、5只眼。试验组患者视力恢复情况优于对照组(P<0.05)。试验组术后并发症发生率为12.5%,低于对照组37.5%(P<0.05)。结论在后段眼内异物患者的治疗上,相对于巩膜外路磁吸术,玻璃体切除取出术具有疗效显著、安全性高的优势,值得临床推广应用。

Objective To observe and explore the clinical effect of different methods of posterior intraocular foreign body extraction. Methods A retrospective case-control study was conducted on 48 patients with intravitreal magnetic foreign bodies who were treated in the Department of Ophthalmology of our hospital from March 2016 to March 2018. The patients were divided into the Experimental Group and Control Group, 24 cases (24 eyes) in each group. The Control Group was treated with scleral magnetic suction while the Experimental Group was treated with vitrectomy. After the operation, the general results, vision recovery and complications of the extraction of intraocular foreign bodies were observed and compared. Results The successful rate of extraction of intraocular foreign body was 100% in the Experimental Group and that was 83.3% in the Control Group. The operation duration and hospital stay in the Experimental Group were significantly lower than those in the Control Group (P<0.05). The best corrected visual acuity examination was performed three months after the operation. There was 1 eye with hand motion, 1 eye with counting fingers, 2 eyes with the visual acuity of 0.05-0.1, 11 eyes with the visual acuity of 0.2-0.4 and 9 eyes with the visual acuity of 0.5 or more in the Experimental Group, and the visual acuity was significantly improved compared with those before the operation;There were 2 eyes with hand motion, 6 eyes with counting fingers, 3 eyes with the visual acuity of 0.05-0.1, 8 eyes with the visual acuity of 0.2-0.4 and 5 eyes with the visual acuity of 0.5 or more in the Control Group. The vision recovery in the Experimental Group was superior to that in the Control Group (P<0.05). The incidence of complications in the Experimental Group was 12.5%, which was lower than that of the Control Group (37.5%)(P<0.05). Conclusion Vitrectomy is more effective and safe than scleral magnetic suction in the treatment of posterior intraocular foreign bodies. It is worth clinical promotion and application in the future.