眼内异物合并感染性眼内炎的急诊玻璃体切割手术疗效观察

Observation of Emergency Vitrectomy Surgery for Intraocular Foreign Bodies Combined with Infectious Intraocular Inflammation

目的分析眼内异物伴眼内炎患者采取玻璃体切割术的疗效。方法纳入2021年4月至2024年4月银川进川眼科医院急诊收治的80例眼内异物合并感染性眼内炎患者,所有患者均进行了急诊玻璃体切割手术治疗。分析所有患者的一般临床资料、眼内异物情况、手术效果、术后视力的影响因素。结果80例患者中,71例为男性(88.75%),9例为女性(11.25%);73例患者为18~65岁之间的中青年(占91.25%);61例患者来自于乡镇(占76.25%)。47例患者眼内异物为金属类(占58.75%),50例患者眼部异物进入区域为I区(占62.50%),43例患者眼部异物较小,直径小于3 mm(占53.75%),65例患者眼部异物嵌顿在黄斑区外(占81.25%)。所有患者眼内异物经Ⅰ期手术均成功取出;术前仅有14例(17.50%)患者术前最佳矫正视力(Best Corrected Visual Acuity,BCVA)≥0.1,而术后一周有33例(41.25%)患者的BCVA≥0.1,手术明显改善了患者的视力情况(P=0.001)。术前BCVA<1、伴视网膜脱离、异物直径≥3 mm是影响患者术后视力恢复的独立危险因素。结论玻璃体切割术可有效改善BCVA,临床疗效显著;且影响患者术后视力的因素主要与术前BCVA、视网膜脱离以及异物直径有关。

Objective To analyze the efficacy of vitrectomy in patients with intraocular foreign body and endophthalmitis.Methods 80 patients with intraocular foreign body with infectious endophthalmitis who treated at Yinchuan Jinchuan Eye Hospital with vitrectomy treatment from April 2021~April 2024 were selected as the study subjects.The basic data,intraocular foreign body,surgical effect,and influencing factors of postoperative visual acuity were analyzed.Results Among the 80 patients,71 were male(88.75%),73 were young or middle-aged who aged 18~65 years old(91.25%),and 61 were from rural areas(76.25%).In 47 patients,the intraocular foreign body was metallic(58.75%).The ocular foreign body in 50 patients was in area I(62.50%),the ocular foreign body in 43 patients was small and less than 3 mm in diameter(53.75%),and the ocular foreign body in 65 patients was incarcerated outside the macula(81.25%).All patients had intraocular foreign bodies successfully removed by stage I surgery.Only 14 patients(17.50%)had a preoperative best corrected visual acuity(BCVA)≥0.1,while 33 patients(41.25%)had a BCVA≥0.1 one week after surgery,and the operation significantly improved the visual acuity of the patients(P=0.001).Preoperative BCVA<1,retinal detachment,and foreign body diameter of≥3 mm were independent risk factors affecting the recovery of postoperative vision.Conclusion Vitrectomy can effectively improve BCVA with significant clinical efficacy.The factors affecting the postoperative visual acuity of patients were mainly related to preoperative BCVA,retinal detachment and foreign body diameter.