Tokoro Mayumi, Yasukawa Tsutomu, Okada Morio, Ogura Yuichiro, Uchida Sunao
Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, Japan.
Int Ophthalmol. 2007 Oct;27(5):329-31. doi: 10.1007/s10792-007-9074-5. Epub 2007 May 15.
The objective is to report a rare case of asymptomatic penetrating injury with a copper foreign body found during an examination for cataract surgery.
A case report.
A 73-year-old woman had vision loss. Examination by pupil dilation disclosed a dark-brown metallic mass located under the anterior capsule of the lens, as well as nuclear sclerosis of the lens. Although no history of traumatic injury was reported by the patient, careful examination revealed a dot corneal opacity. This finding, and the past history of the patient that she had worked in the fabrication of copper wire, suggested previous penetrating injury. The iris had no scar. No inflammatory reaction was observed in the posterior segment of the eye. Phacoemulsification and implantation of an intraocular lens were performed. After continuous curvilinear capsulorrhexis (CCC), the foreign body was extracted with a microforceps. The anterior capsule overlying the foreign body was intact, with normal light reflex. Qualitative analysis showed that the foreign body extracted contained pure copper at the center. Nevertheless, visual acuity of the right eye improved from 20/50 to 20/20 without any copper-related retinal damage.
In this case, copper localized under the anterior capsule of the lens had been able to stay in the eye without causing severe inflammatory reaction.
报告一例在白内障手术检查时发现的罕见无症状穿透伤伴铜异物病例。
病例报告。
一名73岁女性视力下降。散瞳检查发现晶状体前囊下有一个深棕色金属块,以及晶状体核硬化。尽管患者未报告有外伤史,但仔细检查发现角膜有一个点状混浊。这一发现以及患者曾从事铜线制造工作的既往史提示有既往穿透伤。虹膜无瘢痕。眼后段未观察到炎症反应。进行了超声乳化白内障吸除术并植入人工晶状体。连续环形撕囊(CCC)后,用显微镊子取出异物。异物上方的前囊完整,光反射正常。定性分析显示取出的异物中心为纯铜。然而,右眼视力从20/50提高到了20/20,且未出现任何与铜相关的视网膜损伤。
在该病例中,位于晶状体前囊下的铜能够留在眼内而不引起严重炎症反应。