眼内巨大异物摘出术17例临床分析

目的讨论眼内巨大异物的定义、手术方式的选择以及提高治愈率，方法（１）经Ｘ线定位，常规经巩膜取出法；（２）间接检限镜直规定位法；（３）显微镜直视下自睫状体平坦部夹取法；（４）经前房取出法。结果１７例（１８只眼）均为一次手术摘出异物。联合玻璃体切除显微镜直视下摘出异物１３只眼，占７２．２％（二期行眼内容剜出人造骨植人术１只眼）；经巩膜摘出异物５只眼。术后视力提高６只眼，不变９只眼，下降３只眼。结论异物摘出联合玻璃体切除手术损伤小、准确、安全，可减少手术开发症，提高治愈率，是值得推广的手术方式。

Clinical analysis of huge intraocular foreign body extraction in seventeen cases]

OBJECTIVE: To discuss the definition of huge intraocular foreign body (IOFB), the selection of operation and the improvement of cure rate. METHODS: (1) The foreign body was localized by X-ray, and extracted through sclera; (2) direct localization by indirect ophthalmoscope; (3) extraction of IOFB in combination with pars plana vitrectomy (PPV); (4) extraction through anterior chamber. RESULTS: The IOFBs were extracted successfully in all cases. The foreign bodies of 13 eyes were extracted in combination with PPV (72.2%, secondary enucleation with coral porous hydroxyapatite implantation was performed on one case later), and extracted through sclera in 5 eyes. Post-operative visual acuity was improved in 6 eyes, not changed in 9 eyes and decreased in 3 eyes. CONCLUSION: IOFB extraction in combination with PPV is less damaging, accurate and safe, that reduces the complications and enhances the cure rate. It is worth to popularize.