眼后段异物摘出术后再手术的原因分析

Reoperation following the extraction of posterior segment intraocular foreign bodies.

目的 探讨眼后段异物摘出术后再手术的原因。方法 对52例(54眼)眼后段异物摘出术后再手术的病例进行回顾性分析。结果 36眼行内路法异物摘出,18眼行外路磁吸术摘出异物。术后23眼(42.59％)因视网膜脱离或增生性玻璃体视网膜病变而再手术。异物摘出术前11眼伴有视网膜脱离,术后9眼复发;术前5眼伴有眼内炎,术后4眼发生视网膜脱离;视力预后以视网膜脱离或增生性玻璃体视网膜病变及眼内炎最差,81.48％的视力<0.1。结论 视网膜脱离或增生性玻璃体视网膜病变是眼后段异物摘出术后再手术的主要原因,术前伴有视网膜脱离和眼内炎是术后发生视网膜脱离的危险因素。

Objective To investigate the cause of reoperation following the extraction of posterior segment intraocular foreign bodies (IOFB). Methods The records of 52 patients (54 eyes) that were required additional operations after an initial extraction of posterior segment IOFB were analyzed retrospectively.The follow up was from 5 months to 3 years. Results Vitrectomy techniques were used in 36 eyes and electromagnets were used in 18 eyes for extraction of IOFB. 23 eyes (42.59%) had retinal detachments (RD) or proliferative vitreoretinopathy (PVR) that needed reoperations.9 in 11 eyes were preoperative retinal detachment and 4 in 5 eyes were preoperative endophthalmitis developed retinal detachment after the initial operation. RD or PVR and endophthalmitis were associated the worst visual outcome, and the visual acuities of less than 0.1 were 81.48%. Conclusion RD and PVR are the main cause of reoperation following the extraction of posterior segment IOFB. Endophthalmitis is the risk factors for developing postoperative retinal detachment.