CAJ | 학술논문

目的探讨23G玻璃体切除手术治疗金属异物所致眼球贯通伤的效果,分析其有效性及安全性.方法 26例(26眼)因金属异物所致眼球贯通伤,术前常规CT和(或)DR异物定位和(或)眼部B超定位,行角膜和(或)巩膜伤口清创缝合、白内障摘出和(或)同时施行23G玻璃体切除、眼内异物摘出、视网膜激光光凝、C3F8或硅油填充等治疗.术后随访3～24个月.结果 26例经一期或二期23G玻璃体切除手术均顺利摘出异物.大部分患者术后视力有不同程度提高.术后裸眼视力≥0.3者3眼,0.12～ 0.25者5眼,手动～0.1者10眼,光感者6眼,无光感者2眼;术后有19眼解剖及功能修复、视力较术前提高,4眼解剖修复、视力同术前,1眼为硅油依赖眼,1眼眼球萎缩,1眼行眼球摘除术.结论金属异物所致眼球贯通伤行一期处理后适时施行玻璃体切除术,可以改善其预后;23G玻璃体切除术可安全有效地应用于眼球贯通伤患者.
목적 탐토23G파리체절제수술치료금속이물소치안구관통상적효과,분석기유효성급안전성.방법 26례(26안)인금속이물소치안구관통상,술전상규CT화(혹)DR이물정위화(혹)안부B초정위,행각막화(혹)공막상구청창봉합、백내장적출화(혹)동시시행23G파리체절제、안내이물적출、시망막격광광응、C3F8혹규유전충등치료.술후수방3～24개월.결과 26례경일기혹이기23G파리체절제수술균순리적출이물.대부분환자술후시력유불동정도제고.술후라안시력≥0.3자3안,0.12～ 0.25자5안,수동～0.1자10안,광감자6안,무광감자2안;술후유19안해부급공능수복、시력교술전제고,4안해부수복、시력동술전,1안위규유의뢰안,1안안구위축,1안행안구적제술.결론 금속이물소치안구관통상행일기처리후괄시시행파리체절제술,가이개선기예후;23G파리체절제술가안전유효지응용우안구관통상환자.
Objective To investigate the clinical results of 23-gauge vitrectomy for eyeball double perforation by metal foreign body,and analyzes its effectiveness and safety.Methods About 26 eyes of 26 cases of eyeball double perforation by metal foreign body underwent cornea and sclera wound debridement suture,cataract extraction,after or at the same time,intraocular foreign body extraction,23-gauge vitrectomy,and retinal laser photocoagulation,and C3F8 or silicone oil filled.All cases checked CT,OR and (or) B ultrasonic foreign body localization positioned conventionally before operation,and were follow-up for 3-24 months.Results 26 patients with one-stage or two-stage by 23-gauge vitrectomy operation were successfully removed foreign bodies.Postoperative visual acuity improved in varying degrees in many patients.There were uncorrected visual acuity ≥0.3 after operation in 3 eyes,0.12-0.25 in 5 eyes,hand movement to 0.1 in 10 eyes,light perception in 6 eyes,no light perception in 2 eyes.19 eyes repaired the anatomy and function of eyes,as well as improved visual acuity,and 4 eyes repaired the anatomy of eyes with visual acuity as the preoperation,1 eye counted on silicone oil,1 eye was with eyeball atrophy,1 eye underwent enucleation.Conclusion After one-stage operation for patients with eyeball double perforation by metal foreign body can improve the prognosis,with timely treatment of vitrectomy.23-gauge vitrectomy can be safely and effectively used in eyeball double perforation,and be worthy of clinical popularization and application.