多发性角膜深层异物取出临床观察.doc

　　多发性角膜深层异物取出临床观察 ：李仁芳，熊斌，曹泽刚，沈华墨 【摘要】 　　探讨多发性角膜深层异物取出方法。方法：本组患者42例45眼，其中异物穿透角膜全层并部分伸入前房者13例。磁性异物2例，非磁性异物36例，混合性异物4例。未穿透角膜者可用显微镊直接拔出，或作一浅层角膜切开后拔出。穿透角膜者，充分缩瞳，以15°角膜穿刺刀作前房穿刺，确保无房水外漏，黏弹剂自穿刺口注入前房并加深其深度，以顶退的方式自角膜面将异物稍加送出，露出异物尾端，此时不急以拔除，而以相同的手法处理其余异物，待所有异物尾端均露出角膜面后，再以多个有齿镊同时将异物取出。结果：45眼异物42眼顺利取出，3眼因初始取出经验不足导致术后并发性白内障，8眼合并虹膜炎，10眼发生角膜炎均为伤后超过1ethod of multiple cornea indepth foreign bodies removal.METHOD: This group of patient 42 examples (45 eyes), the foreign bodies peration cornea entire level and the part enter anterior chamber 13 examples. The patients are used sedative drugs all over and reduced the pupil fully. Use 15 stab knife to perform paracentesis of anterior chamber to ensure there is no leakage of aqueous humor. Viscoelastic substances are injected from the puncture site into the anterior chamber and then enhance its depth. Use Smooth forceps to dra the cornea surface the foreign bodies to send out slightly, reveals end the foreign bodies, this time not anxiously e, after treating end all foreign bodies reveals the cornea surface, by the same time ,use the tooth forceps to take out the foreign bodies.RESULTS: Fortyfive foreign bodies 42 taken out smoothly, 3 eyes the light concurrency cataract because insufficiently experienced, 8 eyes uveitises. 10 eyes keratitis are surpasses the 1 pt seeing the doctors patient, the Vision improvement probability is higher than 1 ultiple indepth corneal foreign body, especially multiple perability corneal foreign bodys extraction, Should receive a medical examination as soon as possible and the surgery, the surgery designs should take protect the lens as the premise, reduces the surgery plication as far as possible.  　　KEYultiple; cornea indepth; foreign bodies; the surgery treats 　　 0引言 角膜深层异物是眼外伤中的常见病，而多发性角膜深层异物多见于多刺形植物及爆炸伤，角膜异物伤分为磁性和非磁性，角膜深层磁性异物应用磁铁容易取出，而角膜深层非磁性异物，尤其是多发性深层角膜异物取出则有一定困难。取出不当，易造成感染、角膜及晶状体的损伤而影响视力。我地区盛产板栗，因此多发性植物性角膜异物每年均可遇及，我院自200407/200806共收治多发性角膜深层异物42例45眼，均一期手术取出，临床效果满意，现报告如下。 　 　1对象和方法 　　1.1对象