Chung In-Young, Seo Seong-Wook, Han Yong-Seop, Kim Eurie, Jung Jin-Myung
Department of Ophthalmology, Gyeongsang National University Hospital, 90 Chillam-Dong, Chinju, Gyeongnam, Korea.
Yonsei Med J. 2007 Apr 30;48(2):328-30. doi: 10.3349/ymj.2007.48.2.328.
We report the successful removal of a retrobulbar foreign body using a transcranial approach in a 63-year-old patient with a penetrating injury to the left eye. Initial ocular examination revealed a corneoscleral laceration, hyphema, a traumatic cataract, and vitreous hemorrhage. Visual acuity consisted only of the perception of hand motion. Computed tomography demonstrated an orbital foreign body in the retrobulbar area. Emergency corneoscleral suturing, phacoemulsification of the cataract, and vitrectomy with posterior vitreous detachment were performed. Fifteen days after the emergency operation, we successfully removed the orbital foreign body using a transcranial approach, although the foreign body was very close to the optic nerve. On fundus examination 6 months later, a white, fibrous lesion was seen inferior to the optic disc, and the corrected visual acuity was 20/30. These positive results may be due to the complete vitrectomy at the correct time performed by a retina specialist and the minimal pressure on the eyeball while removing the foreign body, which resulted from the use of a transcranial approach.
我们报告了1例63岁左眼穿透伤患者经颅入路成功取出球后异物的病例。初始眼部检查发现角膜巩膜裂伤、前房积血、外伤性白内障和玻璃体积血。视力仅为手动觉。计算机断层扫描显示球后区域有眶内异物。进行了紧急角膜巩膜缝合、白内障超声乳化吸除术以及伴有后玻璃体脱离的玻璃体切除术。紧急手术后15天，尽管异物非常靠近视神经，我们仍经颅入路成功取出眶内异物。6个月后眼底检查发现视盘下方有白色纤维性病变，矫正视力为20/30。这些积极结果可能归因于视网膜专科医生在正确时间进行的完全玻璃体切除术，以及经颅入路在取出异物时对眼球施加的最小压力。
