间接检眼镜直视下眼内磁性异物摘出术治疗体会.docVIP

间接检眼镜直视下眼内磁性异物摘出术治疗体会 　　【摘要】 目的：探讨双目间接检眼镜直视下行眼内磁性异物摘出的临床疗效。方法：将本院2011年 　　10月-2014年2月收治的19例磁性眼内异物者纳入本研究，检眼镜下可见异物位于玻璃体腔13例，视网膜表面4例，嵌顿于视网膜2例。所有患眼均于伤后第1～4天手术，在双目间接检眼镜直视下睫状体平坦部切口经磁铁吸引行异物摘出术。结果：异物均一次性成功摘出，术后因外伤性白内障行手术治疗者5例。随访6个月术后视力提高12眼，不变5眼，视力下降2眼，未见视网膜脱离等并发症的发生。结论：双目间接检眼镜直视下眼后段磁性异物摘出术只要能把握好适应证，不失为一种简单可靠的手术方法。 　　【关键词】 间接检眼镜； 眼内磁性异物； 摘出手术 　　【Abstract】 Objective：To investigate the clinical effect of extraction of magnetic intraocular foreign body（IOFB） under direct vision of binocular indirect ophthalmoscope.Method：19 patients with magnetic intraocular foreign bodies（IOFBs） in our hospital from October 2011 to February 2014 were enrolled in the study.The IOFBs could be seen by the binocular indirect ophthalmoscope，13 cases in the vitreous，4 cases on the surface of the retina and 2 cases embeded in the retina.The magnetic IOFBs were extracted by magnetic-blocks from pars plana under direct vision of binocular indirect ophthalmoscope within 1 day-4 days after the trauma.Result：All the IOFBs were extracted successfully.5 cases had second surgery for traumatic cataracts.In these 19 cases，visual acuities increased in 12 eyes，5 eyes were no change and 　　2 eyes were decreased at 6 months postoperatively and without complications such us retinal detachment.Conclusion：Under direct vision of binocular indirect ophthalmoscope，extraction of posterior segment magnetic IOFB is a simple and reliable operation method，as long as you can grasp the indications. 　　【Key words】 Binocular indirect ophthalmoscope； Magnetic intraocular foreign body； Extraction 　　First-author’s address：The Third People’s Hospital of Dalian，Dalian 116033，China 　　doi：10.3969/j.issn.1674-4985.2015.35.046 　　眼内异物伤是目前造成视功能丧失的重要原因之一。据国外文献[1-2]报道，眼内异物伤约占眼外伤患者的24.7%，且往往伴有角、巩膜穿通伤，前房、玻璃体积血，晶状体损伤，视网膜损伤及视网膜脱离，眼内炎等严重并发症，精准及时地将眼内异物摘出是治疗眼内异物伤、减少术后并发症的关键[3]。眼前段异物相对摘出较易且损伤较小，而眼后段异物因伤情多较复杂，并发症较多其摘出方式也是多种多样。本文就2011年10月-2014年2月在双目间接检眼镜直视下行眼内磁性异物摘出术的19例患者资料作一分析，现报告如下。 　　1 资料与方法 　　1.1 一般资料 将本院2011年10月-2014年2月收治的19例开放性眼外伤伴眼内异