多发性角膜深层异物取出临床观察

目的: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1wk方来就诊者。在伤后3d内及时就诊的患者,术后视力改善几率明显高于1wk者。结论:对于多发性深层角膜异物,尤其是多发性穿透性角膜异物的取出,应争取尽早就诊手术,手术设计应以保护晶状体为前提,尽量减少手术并发症的发生。

Clinical observation of the multiple cornea in-depth foreign bodies removal

·AIM:To discuss the method of multiple cornea in-depth foreign bodies removal.·METHOD:This group of patient 42 examples(45 eyes),the foreign bodies penetration 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 draws back from the cornea surface the foreign bodies to send out slightly,reveals end the foreign bodies,this time not anxiously wipes out,but processes other foreign bodies using the technique of same,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 week to seeing the doctor.After the wound in 3 days the prompt seeing the doctor’s patient,the Vision improvement probability is higher than 1 week obviously.·CONCLUSION:The multiple in-depth corneal foreign body,especially multiple penetrability corneal foreign body’s 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 complication as far as possible.·