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目的探讨玻璃体切割术治疗后节眼球内异物的临床效果。方法对我院1999年1月～2004年10月收治各种后节球内异物95例98眼进行回顾性研究,均采用玻璃体切割联合眼球内异物取出术。按照手术前并发症将研究对象分为眼内炎组、牵拉性视网膜脱离组(Tractionretinaldetachment,TRD)与其它组,分析眼外伤严重程度对预后的影响,按照手术干预距外伤时间分为不同时间组,分析手术时间对眼球内异物预后的影响。结果98眼中93眼后节眼球内异物一次手术取出率为94.0%。出院时视力≥0.01者69眼(69/9870.41%),最好视力0.8。41例随访3个月～25个月,视力<0.01者10眼(10/4124.39%),0.01～0.09者12眼(12/4129.27%),≥0.1者19眼(19/4146.34%)。眼内炎组术后视力≥0.01为31.25%,非眼内炎非TRD组术后视力≥0.01为85.71%,两组比较有显著差异性(χ2=15.25,P<0.005)。TRD组术后视力≥0.01为66.67%,与非眼内炎非TRD组比较,有显著差异性(χ2=4.18,P<0.05)。眼内异物伤后24小时之内进行玻璃体切割眼内异物摘除术,术后视力≥0.01为70.59%,但经χ2处理差别无显著意义。结论玻璃体切割术治疗后节眼球内异物有临床优越性。玻璃体切割眼球内异物取出术后视力恢复与外伤严重程度有关。为防止并发症对术后视力影响,应强调尽早行玻璃体切割眼球内异物取出手术。但需根据眼内炎症的反应、异物的性质及玻璃体视网膜情况决定手术时机。
Objective To investigate the clinical effect of vitrectomy for the treatment of foreign bodies in the posterior segment of the eyeball. Methods A retrospective study was performed on 95 cases of 98 cases of intracapsular foreign bodies treated in our hospital from January 1999 to October 2004. All patients underwent vitrectomy combined with intraocular foreign body removal. According to the preoperative complications, the subjects were divided into three groups: endophthalmitis group, traumatic retinal detachment group (TRD) and other groups. The severity of ocular trauma was analyzed on the prognosis. According to the time of surgical intervention, Group, analysis of the operation time on the prognosis of intraocular foreign body. Results In 98 eyes, 93 eyes were retrospectively analyzed, and the rate of removal of intraocular foreign bodies was 94.0%. There were 69 eyes (69/98 70.41%) with visual acuity of ≥ 0.01 at discharge, the best visual acuity was 0.8.41 cases were followed up for 3 months to 25 months, visual acuity was less than 0.01 in 10 eyes (10/4124.39%), 0.01 ~ 0.09 in 12 eyes (12 / 4129.27%), ≥0.1 were 19 eyes (19 / 4146.34%). The postoperative visual acuity of endophthalmitis group was ≥0.01, which was 31.25%. The postoperative visual acuity of non-endophthalmitis non-TRD group was ≥0.01 = 85.71%. There was significant difference between the two groups (χ2 = 15.25, P <0.005). The postoperative visual acuity of TRD group was ≥0.01, 66.67%, which was significantly different from non-endophthalmitis non-TRD group (χ2 = 4.18, P <0.05). Eye intraocular foreign body within 24 hours after intraocular foreign body removal of vitrectomy, visual acuity ≥0.01 was 70.59%, but no significant difference by χ2 treatment. Conclusion Vitrectomy for the treatment of extraocular foreign body has clinical advantages. Vitreoretinal eyeball removal of foreign body visual acuity recovery and the severity of trauma. In order to prevent complications of postoperative visual acuity, should be emphasized as early as possible vitrectomy eye intraocular foreign body removal surgery. However, according to the reaction of intraocular inflammation, the nature of foreign bodies and vitreoretinal conditions determine the timing of surgery.