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自1985年10月到1987年5月我院共收治了21例眼内铜异物。其中雷管爆炸伤8例,铜片击伤1例,余12例均在拉铜丝时,铜丝断裂致伤。此12例中,9例系乡镇企业的农民工人。16例异物在玻璃体内,2例在晶体后,前房角、睫状体,视网膜上各一例。异物入眼后引起的反应除Duke-Elder 描述的急性化脓性炎症(4例),与慢性铜屑沉着症(2例)外,11例表现为以异物为中心的亚急性,慢性葡萄膜炎或眼内炎。2例异物为机化物包裹,2例可能因就诊早眼内无明显反应。引起眼内不同反应的原因除异物的不同含铜量外,可能还与异物大小,在眼内的部位及机体的不同反应情况有关。取出眼内异物的方法因异物位置而异。我组中16例通过玻璃体切割或晶体玻璃体切割后取出。20例手术眼中,17例取出,手术成功率为85%。手术并发症包括一例巨大异物(11×8×5mm),伤后三周手术,清除大量玻璃体脓液后将异物从玻璃体夹到前房中,再从角膜缘切口取出,术后眼球萎缩。另一例睫状体部位异物、术后葡萄膜反应严重,并发视网膜脱离。通过20例的临床实践经验,眼内铜异物大多是能被安全摘除的。关键是早期诊断,及时手术。
From October 1985 to May 1987 in our hospital were treated with 21 cases of intraocular copper foreign body. Among them, 8 cases were detonated by detonators and 1 case was injured by copper strips. When the remaining 12 cases were pulled copper wire, the copper wire was broken and injured. Of these 12 cases, 9 were rural workers in township and village enterprises. 16 cases of foreign bodies in the vitreous, 2 cases in the crystal, the anterior chamber angle, ciliary body, a case of the retina. In addition to acute suppurative inflammation (4 cases) as described by Duke-Elder, and chronic copper scrapings (2 cases), 11 cases showed subacute, chronic uveitis with foreign bodies or Endophthalmitis. 2 cases of foreign body as the organic matter package, 2 cases may be due to treatment within the early eye no significant reaction. In addition to the different copper content of the foreign body, the reason for different reactions in the eye may also be related to the size of the foreign body, the parts in the eye and the different reactions of the body. The method of removing foreign bodies in the eye varies depending on the location of the foreign body. 16 cases in our group were removed by vitrectomy or vitrectomy. In 20 eyes, 17 cases were removed, and the successful rate was 85%. Surgical complications included a huge foreign body (11 × 8 × 5 mm), surgery three weeks after injury, removal of a large amount of vitreous pus after the foreign body from the vitreous to the anterior chamber, and then removed from the limbal incision, the atrophy of the eye after surgery. Another case of ciliary body foreign body, postoperative uveal reaction, retinal detachment complicated. Through the clinical experience of 20 cases, intraocular copper foreign body mostly can be safely removed. The key is early diagnosis, timely surgery.