摘要
目的探讨金属异物致眼球贯通伤的临床特点、治疗措施、手术时机、手术技巧及其疗效。方法对15例（16眼）金属异物致眼球贯通伤的临床资料进行回顾性分析。结果随诊2周～2年。2眼未手术，视力0．8未见下降。14眼手术术后视力不同程度改善。12眼首次玻璃体视网膜手术视网膜复位，2眼二次玻璃体视网膜手术视网膜复位。眼球壁异物摘出2眼，眶内异物摘出3眼，异物存留者11眼，随诊期内未发现并发症。结论金属异物致眼球贯通伤，创口自闭伴轻度的玻璃体积血可予观察，伴严重的玻璃体积血者，宜伤后7～14d行玻璃体视网膜手术，伴有视网膜脱离或出现感染征象者宜尽早手术。后巩膜创口可用明胶海绵填塞。根据玻璃体状态、视网膜情况选择惰性气体或硅油填充。
Objective To investigate the clinical features of perforating injury of eyeball by metallic foreign body, together with the discussion of the primary treatment, the vitreoretinal surgery time, the surgi- cal technique and the therapeutic evaluation. Method Medical records of 15 cases （ 16 eyes） of ocular perforating injury by metallic foreign body were retrospectively analyzed. Results The follow-up was from 2 week to 2 years. Two cases that had not undergone surgery were resulted in a corrected visual acuity of 0.8. Fourteen patients gained visual acuity increase after operation. The retina reattached in 12 eyes after the first pars plana vitrectomy （PPV） , and in 2 eyes after the secondary PPV. Two foreign bodies on eyeball wall and 3 foreign bodies in orbit were extracted. There was no complication observed in 11 cases with foreign bodies persist in orbit. Conclusion For perforating injury with mild vitreous hemorrhage, medicine treat- ment was used if the wound can be self-closed. For perforating injury with serious vitreous hemorrhage, it is proper to perform vitreoretinal surgery between 7 - 14 days later. For perforating injury with retinal detach- ment or with infection sign, it is proper to carry out vitreoretinal surgery as early as possible. It is a well - advised choice to pack the postern scleral wound by gelatin sponge. Inert gas or silicone oil tamponade were used according to the condition of vitreous body and retina.
出处
《中华眼外伤职业眼病杂志》
2012年第3期161-164,共4页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
基金
云南省科技厅昆明医学院联合专项基金（2009CD195）
关键词
贯通伤
眼球
异物
金属
临床特点
治疗策略
Perforating injury, eyeball
Foreign body, metallic
Clinical feature
Operative management
