眼内睫毛异物迟发性外伤性眼内炎的诊断及治疗

目的 探讨眼内睫毛异物所致迟发性外伤性眼内炎的诊断方法及玻璃体切除联合硅油填充手术的治疗效果。方法 眼球穿孔伤眼内睫毛异物所致合并眼内炎7例（7眼）接受玻璃体切除眼内异物摘出联合硅油填充手术。7眼均于术后3-6月将硅油取出,其中5眼同时行人工晶状体植入术。术前视力0.04-0.1。眼压平均为9mmHg（5-23mmHg）。平均随访12月（3-43月）。结果 眼外伤早期眼部炎症反应不明显。发生眼内炎时间平均为伤后6d（5-7d）。眼内均存在睫毛异物。术后视力0.4-1.0,所有患眼视力均提高。术后眼压平均为17mmHg（10-20mmHg）,显著高于术前眼压（P〈0.05）。术后并发症主要包括前房轻度炎性渗出（2眼）,术后短暂高眼压（1眼）。无视网膜脱离和眼球萎缩。结论 迟发性外伤性眼内炎往往发生于伤后1周左右。导致迟发性外伤性眼内炎的主要原因为眼内睫毛异物存留。玻璃体切除联合硅油填充手术是治疗迟发性外伤性眼内炎的安全有效方法。

Diagnosis and treatment of delayed occurring traumatic endophthalmitis caused by intraocular cilia foreignbody

Objective To explore the diagnosis method and therapeutic effects on delayed occurring traumatic endophthalmitis caused by intraocular cilia foreignbody. Methods Seven eyes of 7 patients with ocular penetrating injury complicated with endophthalmitis underwent vitrectomy combined with silicone oil injection.Silicone oil was removed in 7 eyes from 3 to 6 months postoperatively,and the intraocular lens implantations were performed in 5 of 7 eyes.Preoperative visual acuity ranged from 0.04 to 0.1.The mean preoperative intraocular pressure was 9 mmHg with a range from 5 to 23 mmHg.Follow-up ranged from 3 to 43 months with a mean of 12 months. Results The endophthamlitis was mild at the early stage after ocular injury.The endophthalmitis occurred from 5 to 7 days after ocular injury with a mean of 6 days.All injured eyes had intraocular eyelash foreign body.The postoperative vision ranged from 0.4 to 1.0,and the vision increased in all eyes (100%).The mean postoperative intraocular pressure was 17 mmHg with a range from 10 to 20 mmHg,and was significantly higher than preoperative one (P<0.05).Postoperative complications mainly included mild fibrosis exudates in the anterior chamber (2 eyes) and temporary intraocular pressure elevation (1 eye).There was no retinal detachment and ocular atrophy. Conclusions Delayed occurring traumatic endophthalmitis occurs 1 week after ouclar injury,and is mainly caused by intraocular eyelash foreign body.Vitrectomy combined with silicone oil filling is a safe and effective method in treating delayed occurring traumatic endophthalmitis.