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玻璃体切除术治疗眼后段眼内异物的视觉和解剖学结果。

Vitrectomy for posterior segment intraocular foreign bodies, visual and anatomical outcomes.

作者信息

Falavarjani Khalil Ghasemi, Hashemi Masih, Modarres Mehdi, Parvaresh Mohammad Mehdi, Naseripour Masood, Nazari Hossein, Fazel Ali Jalili

机构信息

Eye Research Center, Rassoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Middle East Afr J Ophthalmol. 2013 Jul-Sep;20(3):244-7. doi: 10.4103/0974-9233.114803.

Abstract

PURPOSE

To evaluate the visual and anatomic results and determine the prognostic factors after pars plana vitrectomy and posterior segment intraocular foreign body (IOFB) removal.

MATERIALS AND METHODS

This retrospective study reviews the patients' charts of 48 consecutive patients with posterior segment IOFB who underwent pars plana vitrectomy and IOFB removal over a 4-year period, recently. Association between visual outcome and various preoperative, operative, and postoperative variables was statistically analyzed. Data were analyzed with the paired t-test and the chi square test. Statistical significance was indicated by P < 0.05.

RESULTS

The mean interval between the time of injury and IOFB removal was 24 ± 43.1 days and 27 (53%) eyes underwent IOFB removal within 7 days of the injury. Nine (19.1%) patients achieved a visual acuity of 20/40 or better. An improvement of visual acuity of at least three lines occurred in 21 (44.6%) eyes and the vision remained unchanged in 15 (31.9%) eyes. Postoperative retinal detachment occurred in five (10.6%) eyes. Visual improvement was more likely to occur in eyes with lower levels of presenting visual acuity (P = 0.2). Visual improvement was not associated with an entry site and IOFB location, lens injury, time to surgery, and pre- and post-operative retinal detachment. At the end of follow up, anatomical success was achieved in 97.9% of eyes.

CONCLUSIONS

High anatomical success could be achieved after the removal of posterior segment IOFBs by vitrectomy, despite a delay in surgery. Poor visual outcome may be mainly due to the initial ocular injury.

摘要

目的

评估玻璃体切割联合眼后段眼内异物(IOFB)取出术后的视力及解剖学结果,并确定预后因素。

材料与方法

本回顾性研究回顾了近期4年内连续48例接受玻璃体切割联合IOFB取出术的眼后段IOFB患者的病历。对视力结果与各种术前、术中及术后变量之间的关联进行了统计学分析。数据采用配对t检验和卡方检验进行分析。P<0.05表示具有统计学意义。

结果

受伤至IOFB取出的平均间隔时间为24±43.1天,27只(53%)眼在受伤后7天内接受了IOFB取出。9例(19.1%)患者的视力达到20/40或更好。21只(44.6%)眼的视力至少提高了3行,15只(31.9%)眼的视力保持不变。术后5只(10.6%)眼发生视网膜脱离。视力较低的眼更有可能出现视力改善(P = 0.2)。视力改善与进入部位、IOFB位置、晶状体损伤、手术时间以及术前和术后视网膜脱离无关。随访结束时,97.9%的眼获得了解剖学成功。

结论

尽管手术延迟,但通过玻璃体切除术取出眼后段IOFB后可获得较高的解剖学成功率。视力预后不佳可能主要归因于最初的眼外伤。

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