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本文报道三例4只视网膜下猪囊尾蚴,1例视网膜下性质不明的囊肿,11例眼底周边部近球壁的非磁性异物及1例视乳头上方嵌入球壁异物,采用间接眼底镜定位后,在手术显微境下逐层切开球壁,取除病变,除1例外均获成功。摘除视网膜下猪囊尾蚴,显微镜下被切开的球壁组织依次为白色的巩膜、黑色无结构的脉络膜上腔色素层、淡棕色布有白色血管纹的脉络膜。切开脉络膜后即见半透明乳白色的囊虫突出于切口中,逐步自动挤出切口外。如为死虫,则要用显微镊、剪,将囊虫与周围脉络膜、视网膜完全分离后再取出。摘除近球壁的非磁性异物有二种情况,异物周围无炎症反应的,切开球壁组织与液化玻璃体流出的同时,异物也被带到切口处,只需将其夹出。异物引起炎症反应的,切开球壁流出液体后,见到白色或黄白色的粘脓样玻璃体,局部脉络膜颜色变深,失去弹性,在最稠厚的脓液或机化物中可找到异物。异物取出后,切口四周冷凝,局部作外加压或加环扎、或玻璃体内注氧。术后无1例发生视网膜脱离,并保持较好的视力,故是一种安全有效的手术方法。
This article reports three cases of 4 subretinal Cysticercus, 1 case of subretinal cyst, 11 cases of fundus near the wall of the non-magnetic foreign body and 1 case of papillary embedding ball wall foreign body, using indirect ophthalmoscope positioning , Cut the ball wall layer by layer under the surgical microscope, remove the lesions, except one case were successful. The subretinal cysticercus was removed. The microstructure of the wall was cut into white sclera, black unstructured choroidal parenchyma and light brown cloth with choroid. Open the choroid after see translucent white cysticercosis prominent in the incision, gradually out of the incision automatically. If dead insects, then use microscopic tweezers, scissors, the cysticercosis and the surrounding choroid, retinal detachment and then removed. Removal of near the wall of the non-magnetic foreign body in two cases, no inflammatory reaction around the foreign body, cut the ball wall tissue and liquefied vitreous outflow at the same time, foreign bodies have also been brought to the incision, just pinch it out. Foreign body caused by inflammatory reaction, cut the ball wall out of the liquid, see the white or yellowish white pus-like vitreous, local choroidal color becomes dark, loss of elasticity, in the most thick pus or machine can be found in foreign matter. After the removal of foreign body, the incision around the condensation, the local external pressure or add cerclage, or intravitreal injection of oxygen. No case of postoperative retinal detachment, and maintain good vision, it is a safe and effective surgical method.