23G玻璃体切除术及硅油辅助取出眼内巨大异物的临床观察  

Removal of giant intraocular foreign body with the assistance of silicone oil tamponade in 23G vitrectomy

作　　者：陈忠平[1,2] 覃星妹 张婷婷 陈娟 Zhong-Ping Chen;Xing-Mei Qin;Ting-Ting Zhang;Juan Chen(Department of Fundus Disease,Changsha Aier Eye Hospital,Changsha 410015, Hunan Province,China;Aier School of Ophthalmology,Central South University,Changsha 410000,Hunan Province, China)

机构地区：[1]长沙爱尔眼科医院眼底病科,中国湖南省长沙市410015 [2]中南大学爱尔眼科学院,中国湖南省长沙市410000

出　　处：《国际眼科杂志》2018年第1期172-174,共3页International Eye Science

基　　金：长沙市科技计划项目(No.kq1602026);爱尔眼科医院集团科研基金项目(No.AF1601D5);湖南省卫生计生委课题(No.C2015-69)~~

摘　　要：目的:研究23G微创玻璃体切除术及硅油辅助下取出眼内巨大异物的手术效果及并发症。方法:回顾性分析2012-02/2015-03在长沙爱尔眼科医院接受治疗、需填充硅油的眼内巨大异物的患者12例12眼,其中男11例11眼,女1例1眼。术前视力光感~0.1,12眼术前均合并视网膜脱离。所有患者均接受23G微创玻璃体切除手术,在切除玻璃体和修复损伤的视网膜后,先行硅油填充,再扩大巩膜切口取出眼内巨大异物。术后6mo取硅油,部分患者联合人工晶状体植入。结果:患者12眼眼内巨大异物均一次性取出,未出现再次跌落损伤视网膜现象,切口无视网膜脱出,不损伤角膜。术后视网膜均复位,未出现术后眼内炎。术后6mo硅油均顺利取出,视力均提高,脱盲率达67%,脱残率达到25%。结论:23G微创玻璃体切除术及硅油辅助下取出眼内巨大异物是一种安全有效的方法。AIM:To evaluate the outcomes and safety of minimally invasive23G pars plana vitrectomy(PPV)combined with silicone oil tamponade for the removal of giant intraocular foreign body(IOFB).METHODS:A total of12cases diagnosed with giant IOFB were included in this retrospective study in which11eyes of11males and1eye of1female were treated in Changsha Aier Eye Hospital between February2012and March2015.Among these patients,the preoperative best corrected visual acuity varied from light perception to0.1with retinal detachment identified in all12eyes.All patients underwent23G minimally invasive PPV.After the vitreous was removed and the damaged retina was repaired,silicone oil was filled,and then the scleral incision was extended to remove the giant IOFB.Lens extraction and intraocular lens implantation were performed in some patients when necessary.Silicone oil was removed6mo later.RESULTS:The giant IOFB was removed successfullyjust with1attempt in each of12eyes,and no IOFB fell and reinjured the retina or damaged the cornea during the procedure.All retinas were reattached and no endophthalmitis was observed in any patients postoperatively.The silicone oilwas removedsuccessfully after6mo,and by then the visual acuity was improved in all cases.Sixty-seven percent of patients became free of blindness and25%free of visual disability.CONCLUSION:Removing giant IOFB through23G PPV assisted with silicone oil tamponade is safe and effective.

关 键 词：眼内异物 玻璃体切除术 硅油 眼损伤 

分 类 号：R779.6[医药卫生—眼科]