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金属眼内异物合并外伤性白内障行巩膜角膜隧道切口及巩膜睫状沟固定型人工晶状体植入的玻璃体切割术治疗的视力预后

Visual outcome of pars plana vitrectomy with intraocular foreign body removal through sclerocorneal tunnel and sulcus-fixated intraocular lens implantation as a single procedure, in cases of metallic intraocular foreign body with traumatic cataract.

机构信息

Vitreo Retinal Service, JPM Rotary Eye Hospital and Research Institute, Sec-6, CDA, Bidanasi, Cuttack, Orissa-753 014, India.

出版信息

Indian J Ophthalmol. 2010 Mar-Apr;58(2):115-8. doi: 10.4103/0301-4738.60077.

Abstract

AIM

To evaluate visual outcome following pars plana vitrectomy (PPV) and intraocular foreign body (IOFB) removal through the sclerocorneal tunnel combined with simultaneous cataract extraction and sulcus-fixated intraocular lens (IOL) implantation as a single procedure in penetrating ocular trauma with IOFB and traumatic cataract.

MATERIALS AND METHODS

Eighteen cases of penetrating ocular trauma with retained IOFB and traumatic cataract who underwent PPV, IOFB body removal and cataract extraction with posterior chamber IOL (PCIOL) implantation in the same sitting, between June '04 and December '05 were retrospectively analyzed. All the foreign bodies were removed through the sclerocorneal tunnel.

RESULT

All the 18 patients were young males, with an average follow-up period of 12 months. In 12 cases the foreign body was intravitreal and in six cases it was intraretinal but extramacular. Thirteen cases had a best corrected visual acuity ranging from 20/20 to 20/60 at their last follow-up. Five cases developed retinal detachment due to proliferative vitreoretinopathy (PVR) changes postoperatively and were subsequently managed by surgery.

CONCLUSION

Primary IOL implantation with combined cataract and vitreo-retinal surgery is a safe option reducing the need for two separate surgeries in selected patients with retained IOFB and traumatic cataract. This combined procedure provides good visual outcome with early rehabilitation in young working patients.

摘要

目的

评估眼穿透伤伴眼内异物和外伤性白内障患者采用巩膜角膜隧道切口联合白内障超声乳化摘除、后房型人工晶状体(IOL)植入治疗眼内异物的同时处理白内障的手术效果。

材料与方法

回顾性分析 2004 年 6 月至 2005 年 12 月我院收治的 18 例眼穿透伤伴眼内异物和外伤性白内障患者,均采用巩膜角膜隧道切口联合白内障超声乳化摘除、后房型 IOL 植入术治疗眼内异物和白内障。

结果

18 例患者均为年轻男性,平均随访 12 个月。12 例异物位于玻璃体内,6 例位于视网膜内但未累及黄斑。末次随访时,13 例患者最佳矫正视力为 20/20 至 20/60,5 例患者因术后发生增生性玻璃体视网膜病变(PVR)而出现视网膜脱离,后经手术治疗。

结论

对于眼内异物和外伤性白内障患者,采用一期 IOL 植入联合白内障及玻璃体视网膜手术是一种安全的选择,可以减少在某些选择病例中进行两次单独手术的需要。这种联合手术为年轻的工作患者提供了良好的视力预后和早期康复。

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