裂隙灯显微镜联合荧光素染色检查法在眼表隐匿性异物诊治中的应用  

Application of slit lamp microscopy combined with fluorescein staining in diagnosis and treatment of concealed foreign body on ocular surface

作　　者：汤伟民 陈德钦 王涛[2] 凌士奇[2] 

机构地区：[1]新会区人民医院眼科,广东省江门市529100 [2]中山大学附属第三医院眼科,广东省广州市510630

出　　处：《眼科新进展》2013年第4期338-340,共3页Recent Advances in Ophthalmology

基　　金：国家自然科学基金资助(编号:30700927);广东省自然科学基金资助(编号:S2011010006061)~~

摘　　要：目的介绍一种眼表隐匿性异物诊治的方法。方法回顾分析了27例眼表隐匿性异物的眼部临床特点及检查、治疗方法。结果 27例患者均为单眼患病,其中男14例,女13例,年龄的中位数为29岁,四分位间距为25岁、39岁,症状持续时间的中位数为2.0d,四分位数间距为0.5d、4.0d。各类异物中,角膜异物9例,结膜异物18例。在异物取出之前,所有患眼用裂隙灯显微镜检查时均未见明显的眼表损害。裂隙灯显微镜联合荧光素染色检查时发现,眼表隐匿性异物具有特征性改变,包括"荧光素着色"和"荧光素边集",其中表现为"荧光素着色"的比例为44.4%,表现为"荧光素边集"的比例为92.6%。15例异物可直接用湿棉签抹除,4例用显微镊夹出,其余8例采用联合异物取出法。在异物取出之后,裂隙灯显微镜联合荧光素染色结果显示,4眼未见明显着色,2眼呈片状着色,21眼为点状或线状着色。所有患者均未见因异物导致的眼部感染。结论通过查找特征性改变,裂隙灯显微镜联合角膜荧光素染色检查法有助于眼表隐匿性异物的诊治。Objective To introduce a method for the diagnosis and treatment of concealed ocular surface foreign body on ocular surface.Methods A retrospective analysis of the ocular clinical features,examination and therapeutic method of 27 cases with concealed ocular surface foreign body was conducted.Results All 27 patients suffered monocular condition,among which male were 14,female were 13.The median age was 29 years,with a range interquartile 5 years and 39 years;The median duration of symptoms was 2.0 days,with a range interquartile 0.5 day,4.0 days.The type of foreign body in 9 cases were corneal,18 cases were conjunctival.No obvious ocular trauma was observed by slit lamp microscopy before the foreign body was removed.When examined by slit lamp microscopy combined with fluorescein staining the concealed foreign body showed characteristic changes,which including fluorescein staining and fluorescein gathering.The rate of fluorescein staining was 44.4%,the rate of fluorescein gathering was 92.6%.Of all 27 cases,the concealed foreign body in 15 cases were removed directly using wet cotton buds,4 with micro forceps,8 with the combined methods.Result of the examination of the slit lamp microscope and fluorescein staining showed that after the removal of the concealed foreign body,4 cases showed no visible staining,2 cases showed sheet staining,21 cases showed punctate or linear staining.No ocular infection was observed during the treatment.Conclusion The combined method of slit lamp microscopy and fluorescein staining can improve diagnosis and treatment of concealed foreign body on ocular surface by helping to detect characteristic changes in the concealed foreign body.

关 键 词：眼表 眼外伤 异物 荧光素染色 

分 类 号：R776.1[医药卫生—眼科]