后段眼内异物的手术处理

目的 评价后段眼内异物的后路摘出法及经玻璃体摘出法的效果及影响因素。方法 后段眼内异物126例(126眼)中36眼行伤后初期清创缝合联合后路异物摘出术，90眼行玻璃体切除联合眼内异物摘出术，其中晶状体切除玻璃体切除32眼，玻璃体切除联合眼内激光24眼，玻璃体切除联合硅油填充20眼，玻璃体切除联合c3F8填充14眼。结果 126眼均成功摘出异物。术后视力≥0．5者占30．16％，0．2—0．4者占37．3％，0．05—0．1者占14．29％。后路异物摘出术后发生PVR6眼占16．67％，而玻璃体切除联合眼内异物摘出术后发生PVR5眼，仅占5．56％。结论 后路异物摘出适用于异物较小，晶状体透明，玻璃体透明或轻度浑浊者。提倡玻璃体切除联合眼内异物摘出术。

Surgical management of posterior segment intraocular foreign bodies

Objective To evaluate the efficacy and influence of surgical management for the intraocular foreign body (IOFB) . Methods 126 cases ( 126 eyes) of IOFB were reviewed retrospectively. 36 cases underwent a External pathway to remove the IOFBs. While a pars plana vitrectomy (PPV) plus IOFB extraction was performed in another 90 cases, the different measures including lensectomy in 32 cases, endolaser treatment in 24 cases, silicone oil injection in 24 cases. C3F8 tamponade in 14 cases. Results The lOFBs of 126 eyes were extracted successfully. Visual acuity improved in 81 eyes (64.3%), No changed in 27 eyes (21.4%), and decreased in 18 eyes (14.3%). Postoperative visual acuity was 0.5 or better in 38 eyes (30.16% ) , 0.2 - 0.4 in 47 eyes (37.3%), 0.05-0.1 in 18 eyes (14.29%). The external pathway to remove the lOFBs associated with proliferative vitreoretinopathy (PVR) in 6 cases (6/36, 16.67%). Only 5 cases PVR in PPV combined with IOFB extraction (5/90,5.56%) .Conclusion Extraction of IOFB via external pathway is applied for small foreign bodies, transparency lens, mild vitreous hemorrhage only.PPV combined with endolaser and tamponade is an effective procedure in the treatment of posterior foreign bodies.