玻璃体切除眼内异物摘出术后的视力恢复分析  

The analysis of visual acuity after 23G vitrectomy combined with intraocular foreign body extraction

作　　者：高雪霞[1] 范志华[1] 王瑞峰[1] 田野[1] 

机构地区：[1]郑州市第二人民医院眼科450052

出　　处：《中华眼外伤职业眼病杂志》2016年第11期851-854,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的：分析23 G玻璃体切除及后段眼内异物摘出联合手术后视力及其影响因素。方法2013年1月至2014年9月我科进行的玻璃体切除及后段眼内异物摘出78例（78眼）,对手术前后视力,异物摘出时机及术前相关临床资料进行回顾性分析。结果异物摘出成功率100%。术前视力≥0.1者为22例（28.2%）；术后视力≥0.1者45例（57.7%）。从受伤至异物摘出的时间平均为（25.7±6.4） d,其中48例（61.5%）于受伤7 d内摘出异物。尽早摘出异物者,术后视力较好；术前眼球损伤重者,术后视力恢复较差；异物通过角膜进入眼内者,术后视力较差；术前合并眼内炎者,术后视力较差。术后视力与外伤性白内障、视网膜脱离、脉络膜脱离无关。结论玻璃体切除联合后段眼内异物摘出成功率高、视力恢复好。原始的眼损伤是影响视力预后的重要因素。术后视力与手术时机、异物进入眼内通道及术前眼内炎有关。Objective To analyse the visual results and related influencing factors after 23 G pars plana vitrectomy combined with intraocular foreign body （ IOFB） extraction. Methods The data of 78 eyes of 78 patients with IOFB who underwent pars plana vitrectomy （ PPV ） and IOFB extraction from January 2013 to September 2014 were retrospectively reviewed. The visual acuity before and after surgery,the best surgery time for IOFB extraction and preoperative clinical data were recorded. Results The success rate of the extraction of IOFB was 100%. Preoperative visual acuity was ≥0. 1 in 22 eyes （28. 2%）. The postoperative visual acuity was ≥0. 1 in 45 eyes（57. 7%） （χ2 =4. 158,P=0. 041） . The mean time from injury to IOFB extraction was （25. 7 ± 6. 4） days and the IOFB was removed within 7days after injury in 48 eyes. Factors showed statistical association with postoperative visual acuity included preoperative visual acuity, the time of IOFB extraction surgery, entry way of IOFB and endophthalmitis. Factors showed no statistical association with final visual acuity included traumatic cataract, retinal detachment and choroidal detachment. Conclusion PPV combined with IOFB extraction has high success rate with better postoperative visual acuity. Visual outcome after surgery is associated with the time of surgery,entry way of IOFB and preoperative endophthalmitis.

关 键 词：玻璃体切除术 异物 眼内 摘出术 视力 

分 类 号：R779.6[医药卫生—眼科]