内路与外路手术治疗眼内磁性异物的疗效分析  

Analysis of efficacy of vitrectomy and magnetic extraction for intraocular magnetic foreign body removal

作　　者：袁志刚[1] 韩金栋[1] 颜华[1] 

机构地区：[1]天津医科大学总医院眼科,300052

出　　处：《中国实用眼科杂志》2011年第12期1290-1292,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的分析并比较内路与外路手术治疗眼内磁性异物的效果。方法回顾分析手术治疗89例（89只眼）眼球穿通伤合并眼内磁性异物的临床资料，其中58只眼行内路手术，即清创缝合后二期行玻璃体切除术取出异物；31只眼行外路手术，即一期行清创缝合联合电磁铁异物吸出术，观察并比较两组异物取出率、术中及术后并发症发生情况及随访末期的视力，分析两组患者视力预后的影响因素。结果随访末期视力提高者占74．5％。内路及外路组一次性异物取出率分别为100％、93．5％，二者比较，差异无统计学意义。（P=0．119）两组随访末期视力改善率分别为79．3％、64．5％，二者比较，差异亦无统计学意义。（x2=2．307，P=0．129）异物大小及伤口部位对随访末期视力的影响，差异有统计学意义。（x2=8．350，P=0．004；Xz=6．230，P=0．013）。术后并发症：内路组视网膜脱离者10只眼，硅油填充术后高眼压者2只眼；外路组视网膜脱离者1只眼，眼内炎1只眼。结论如手术适应证选择得当，两种手术方式取出眼内磁性异物的一次性手术成功率及预后视力无统计学差异。影响术后视力的主要因素为眼内异物大小和异物穿入眼球部位。Objective To analyze the therapeutics effect of vitrectomy and magnetic extraction on posterior segment intraocular magnetic foreign body removal Methods Clinical data of 89 cases （89 eyes） with foreign bodies were retrospective analyzed, 31 eyes underwent with electrolyzer magnetic extraction, and the other 58 eyes underwent vitrectomy extraction. The surgery methods, diameter of foreign body and the location of penetrating wound were analyzed as risk factor to the recovery of visual acuity at the end of follow up. Results About 74.5% patients had good outcome of visual acuity at the end of follow up. The successful rate of foreign body removal in vitrectomy group was 100% and in magnetic extraction group was 93.5%, There was no statistic significant difference （P =0.119）. At the end of follow up, the percentage of patient with good visual acuity outcome in the two groups were 79.3% and 64.5% respectively and there were also no statistic significant difference （X 2=2-307, P =0.129）. The risk factors of visual acuity outcome were diameter of foreign body and the location of penetrating wound （X 2=8.350, P =0.004; X2=6.230, P =0.013）. After surgery there were 10 patients had retinal detachment in vitrectomy group and 1 patient in magnetic extraction group; 1 patient had endophthalmitis in magnetic extraction group and there were 2 patients with sili- con oil tamponade had high intraocular pressure. Conclusions After properly choosing patients, there is no statistic significant difference of final visual acuity and foreign body removal rate between vitrectomy and magnetic extraction group. The risk factors of final visual acuity are the diameter foreign body and the location of penetrating wound.

关 键 词：磁性异物吸出术 玻璃体切除术 眼内磁性异物 

分 类 号：R779.14[医药卫生—眼科]