玻璃体切割术治疗眼球内异物13例疗效分析

目的评价玻璃体切割术治疗眼球内异物伤的治疗效果。方法对我院2007—2009年收治的13例球内异物经玻璃体切割术治疗进行观察。结果球内异物均取出,大部分患者视力恢复较好。结论玻璃体切割术是治疗眼球内异物的有效方法。     

球内异物伤玻璃体切割术后视乳头区荧光造影观察

目的 观察球内异物伤玻璃体切割术后视乳头区的眼底荧光造影(FFA)特征.方法 观察行玻璃体切割手术的19例(21眼)球内异物伤病例,术后2~6个月行FFA检查.结果 球内异物伤玻璃体切割术后,5眼出现视乳头早期局部弱荧光,12眼出现视乳头后期强荧光.结论 球内异物伤玻璃体切割术后,视乳头异常荧光改变比例较高,提示玻璃体切割术后视乳头处血管损伤比例可能较高,这可能为玻璃体切割术后视力不佳原因之一.     

眼外伤球内异物玻璃体切割术的护理

眼外伤球内异物是眼科常见的危重眼病。异物进入眼内可造成眼部组织机械性损伤，引起眼内感染、白内障、继发性青光眼、虹膜睫状体炎及视网膜脱离等。若不及时取出异物，最终会引起眼球萎缩，视力丧失。因此，早期手术取出球内异物是挽救视力，减少伤残致盲率的有效治疗手段。同时，周到的精心护理，对确保手术疗效，预防并发症，促进患者早日康复，亦具有积极的临床意义。现将我院2003年1月～2006年6月行玻璃体手术取出球内异物的护理体会报告如下。     

球内异物并发感染性眼内炎行玻璃体切除治疗1例报告

病例男，26岁，2005年1月23日在敲击石块时，被反弹的石屑击伤右眼。伤后即感右眼疼痛，流泪，视物不清，当时未曾诊治。一周后自觉右眼仍疼痛，且视物不清症状逐渐加重。至当地医院就诊，诊断为“外伤性角膜炎”，给予抗生素眼液点眼及全身抗感染等治疗，症状未见明显好转。10d后，在保定市某医院就诊，行眼球CT检查，发现右眼球内异物。患者由于经济原因，于2005年2月26日至我院就诊。眼科检查：视力：右眼：指数／30cm左眼：0．8；右眼结膜混合充血（＋＋），角膜上皮水肿、混浊，角膜中央偏颞下方可见小片状角膜云翳，角膜未见明显裂伤。前房深浅正常，前房混浊，可见白色絮状渗出，前房积脓约2mm。虹膜未见前、后粘连，未见明显伤口。瞳孔双侧等大，约4mm，右眼直接及间接对光反射均迟钝。晶体未见明显混浊，玻璃体及眼底窥视不清。左眼前节及眼底未见异常。眼压：右眼21．3mmHg；     

眼外伤球内后段异物的手术处理

目的评价眼外伤球内后段异物的玻璃体切割术摘除法及后径摘除法的效果及影响因素。方法本组眼外伤球内后段异物共62例(62眼),其中32例行玻璃体切割术联合异物摘除术,30例行外伤后初期清创缝合联合后径异物取出术,前者采用常规睫状体平坦部三切口闭合式玻璃体切割,联合白内障晶状体切除或硅油填充或全氟丙烷(C3F8)气体填充或巩膜外加压术或环扎术,异物经前房或睫状体平坦部用异物镊夹出;后者异物的定位后从巩膜切口取出。结果玻璃体切割术组异物取出率100％;后径取出术组异物取出率86．67％(26／30)。术后视力：玻璃体切割术组提高或不变25例,下降7例;后径取出术组提高或不变13例,下降17例。结论玻璃体切割术可以准确有效地取出各种异物,而且损伤小,能最大限度地恢复视功能。后径取出术适合异物较小、晶状体玻璃体透明者。     

玻璃体切割术治疗眼外伤眼内异物存留的临床疗效观察

目的　探讨玻璃体切割术治疗眼外伤眼内异物存留的方法、效果和并发症。方法　分析 3 2例眼内异物玻璃体切割术的病例 ,采用常规睫状体平坦部三切口闭合式玻璃体切割联合巩膜外加压术或环扎术 ,异物经前房或睫状体平坦部取出。结果　异物取出率 10 0 %,术后视力提高明显 :视力 0 0 5～ 0 3由术前 4例提高到 15例 ,0 4以上者由 2例提高到 6例。结论　玻璃体切割术可以准确有效地取出各种异物 ,而且损伤小 ,能最大限度地恢复功能     

玻璃体切割术后的白内镜摘除及人工晶体植入

随着玻璃体切割手术在眼科领域越来越广泛的应用 ,玻璃体切割术后白内障的发生逐年提高 ,特别是玻璃体切割术中行长效气体充填及硅油注入者 ,白内障的发生率几乎近 10 0 %。再次为患者行白内障手术 ,提高患者的视功能 ,改善其生存价值 ,已成为眼科医生所关注的问题。因玻璃体切割术后患者眼压普遍偏低 ,术中操作较常规手术难度增加 ,术后视力影响因素多。玻璃体腔内硅油未取出情况下是否能行人工晶体植入 ,也存在争议。我院自 98年 1月至 99年 3月采用白内障现代囊外摘除术或超声乳化吸出术治疗玻璃体切割术后白内障 19例 19眼。术后效果良…     

CT对球内异物定性定位的诊断价值

眼球穿通伤是眼外伤的常见疾病,往往合并有球内异物,玻璃体积血并发眼内感染等,及时取出球内异物对保护眼球的功能至关重要.本文对CT在球内异物的定性、定位的诊断中的价值进行了研究.     

玻璃体切割术治疗急性视网膜坏死

急性视网膜坏死（acuteretinalmecrosisARN）是严重损害视功能的眼临床综合征。主要表现为急性葡萄膜炎、玻璃体炎、视网膜血管炎、坏死性视网膜炎和孔源性视网膜脱离。1971年首先由日本学者描述，当时称作桐泽型葡萄膜炎。1977年美国报道了同样的病例，称作坏死性血管闭塞性视网膜炎。1978年Young和Bird发现该病的双眼病例，又命名为双眼急性视网膜坏死。现统一命名为急性视网膜坏死。由于单纯药物治疗效果不良，故对1996年1月至1997年5月收治的6例6眼急性视网膜坏死患者同时施行玻璃体切割术，获得满意疗效。现报告如下：1临床资料与方…     

球内异物延误治疗引起严重并发症1例

现将1例球内异物因延误治疗而引起严重并发症报告如下。     

Assessment of intraocular foreign bodies by helical-CT multiplanar imaging

The aim of this study was to examine the effectiveness of helical CT in the assessment of intraocular foreign bodies, evaluating two protocols with different collimation. We performed helical-CT studies in 30 patients. Fifteen patients were examined with 1.5-mm collimation and the other 15 patients with 3.0-mm collimation. All other imaging parameters were identical in both protocols. Multiplanar images were reconstructed. The examinations were reviewed for presence, localization and size of intraocular foreign bodies. We compare our results with the surgical data. We estimate the required examination time. In the first group (collimation 1.5 mm) an intraorbital foreign body was detected in 8 of 15 patients. In 3 of 8 patients an intraocular foreign body (all were metallic) was detected. In the second group (collimation 3.0 mm) an intraorbital foreign body was detected in 9 of 15 patients. In 8 of 9 patients an intraocular foreign body (all were metallic) was detected. Our results were confirmed by surgery in all cases. Examination time was 36 s in the first group and 18 s in the second group. Computed tomography should be considered the imaging modality of choice in the assessment of metallic intraocular foreign bodies and 3.0-mm collimation is optional, because of reduced examination time and radiation exposure. Electronic Publication     

Intraorbital wooden and bamboo foreign bodies: CT

We describe the CT findings of intraorbital wooden and bamboo foreign bodies in the acute, subacute, and chronic stages. We examined four patients using CT a total of seven times. The CT findings were reviewed. There were three dry wooden foreign bodies. CT within a day of the accident demonstrated wooden foreign bodies as low density relative to surrounding orbital fat, while CT 8–29 days after the accident showed them as denser than the extraocular muscles. In the acute stage, dry wooden foreign bodies mimic air bubbles. Wooden foreign bodies in the subacute and chronic stages should be included in the differential diagnosis of intraorbital lesions of soft tissue density or above on CT of traumatised orbits. There was one dry bamboo foreign body. Within a day of the accident it was recognised as linear lesion isodense with fat. Therefore, such foreign bodies may be missed on CT when located in the orbital fat. Received: 6 March 1996 Accepted: 15 May 1996     

Tiny ferromagnetic intraocular foreign bodies detected by magnetic resonance imaging: A report of two cases

We report two cases with tiny ferromagnetic intraocular foreign bodies (FBs) that were demonstrated only on magnetic resonance imaging (MRI) and confirmed by subsequent ophthalmologic operation. Both of the patients had a history of ocular trauma and their clinical symptoms were compatible with an intraocular FB. Plain x‐ray film, 3 mm slice thickness computed tomography (CT) scans (Toshiba TXT 600 system and GERP22 system), B‐scan ultrasonography, and an MRI study (Siemens Impact 1.0 MR system) were acquired. MR examinations were performed using spin‐echo (SE) T1, T2, and PD‐weighted axial and sagittal or coronal images with 3 mm slice thickness. Plain x‐ray film, 3 mm slice thickness CT scans and B‐scan ultrasonography all failed to demonstrate any tiny intraocular FBs in these two patients, whereas MRI revealed tiny ferromagnetic FBs due to their characteristic magnetic susceptibility artifact. A ferromagnetic FB was found in the vitreous body of each patient, which were 0.375 × 0.3 × 0.15 mm and 0.5 × 0.4 × 0.2 mm, respectively, and there was no evidence of MR‐induced damage. We suggest that tiny ferromagnetic fragments with a diameter below 0.5 mm, which are too small to be visualized by x‐ray plain films and CT images, may be visualized on MR images. These tiny ferromagnetic particles may not be large enough to cause ocular damage during a 1.0T MRI examination. MRI may be a useful tool in the evaluation of tiny intraocular ferromagnetic FBs if other imaging modalities such as plain s‐ray, CT scan, and ultrasonography failed to do so. Further evaluation with a large‐scale study (in vitro and in vivo animal study) for the safety of detecting tiny (<0.5 mm) intraocular ferromagnetic particles is warranted. J. Magn. Reson. Imaging 2009;29:704–707. © 2009 Wiley‐Liss, Inc.     

CT appearances of chronically retained wooden intraorbital foreign bodies

Identification of wooden intraorbital foreign bodies (WIOFB) is crucial for avoiding severe orbital infection. Despite careful clinical examination, WIOFB are often not recognised. We report the CT findings in chronically retained WIOFB. When not initially diagnosed, WIOFB create a granulomatous inflammatory foreign-body reaction. CT demonstrates the WIOFB as a linear dense structure surrounded by a soft-tissue mass with density similar to that of muscle, corresponding to the foreign-body reaction.     

上消化道异物的内镜处理--附802例报告

目的 积累内镜诊断及处理上消化道异物的经验。方法 回顾性分析我院1978年1月～2003年1月,总结分析802例吞入异物的患者进行紧急内镜检查和在局麻或全麻下应用辅助器械配合内镜处理异物的情况。结果 802例患者中共有1198件异物,其中异物位于食管内424件、胃内662件、十二指肠112件。共有780例1167件异物经内镜成功取出,未出现严重并发症;尚有22例31件异物,因异物尖锐端嵌顿严重等原因未取出。成功率为97.3％。在取出的异物中,最大异物长20cm、宽4.2cm。结论 应用内镜取出消化道异物是安全、有效的。     

Pharmacoradiologic disimpaction of esophageal foreign bodies: Review and recommendation

The use of pharmacologic agents to relieve distal esophageal food impaction has been reported with varying degrees of success. This review defines the role of pharmacoradiologic disimpaction and outlines a radiologic strategy of examination and disimpaction. All reports using glucagon and other pharmacologic agents to relieve esophageal food impaction were reviewed, and the reasons for the variability of their results were assessed. Glucagon has a reported success rate of 37–75%. The technique of examination appears to be the most important factor in determining the success of intervention. Performed as outlined in this review, pharmacoradiologic disimpaction of a lower esophageal food bolus is a reasonable, efficient, safe, and inexpensive first line of management.     

玻璃体切割联合眼内注药治疗外伤性眼内炎疗效分析

目的 观察玻璃体切除联合玻璃体内注药治疗外伤性眼内炎的疗效。方法 对42例外伤性眼内炎行玻璃体切除联合玻璃体内注药治疗,并对其临床资料进行分析。结果 42例患者35眼视力有不同程度提高,5眼眼球萎缩,2眼因炎症未控制行眼球摘除。结论 玻璃体切除联合玻璃体内注药是治疗外伤性眼内炎的有效方法,早期诊断、及时治疗是挽救眼球和视功能的关键。