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视网膜内异物:手术技术与结果

Intraretinal foreign bodies: surgical techniques and outcomes.

作者信息

Feghhi Mostafa, Dehghan Mohammad-Hossein, Farrahi Fereydoun, Moghaddasi Alireza, Rastegarpour Ali

机构信息

Infectious Ophthalmologic Research Center, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J Ophthalmic Vis Res. 2013 Oct;8(4):330-6.

Abstract

PURPOSE

To report the clinical features of eyes with intraretinal foreign bodies (IRFBs) and to evaluate the results of surgical management in these eyes.

METHODS

Hospital records of 34 eyes of 33 patients with IRFBs were reviewed. All eyes underwent pars plana vitrectomy to remove the foreign bodies using intraocular forceps or by magnetic extraction.

RESULTS

All patients were male with mean age of 28±12.3 years and were followed for a mean period of 24.5±2.3 months. The IRFBs were ferromagnetic in 29 (85.3%) cases and were removed using an external magnet in 13 eyes (38.4%) or intraocular forceps in 21 eyes (61.6%). Laser photocoagulation was performed around the IRFB prior to surgery in 7 (20.6%) eyes. Macular pucker and scars developed in 8 (23.5%) eyes and retinal breaks posterior to the sclerotomy were formed in 12 eyes (35.3%) postoperatively. Final visual acuity was 20/40 or better in 12 (35.3%) eyes and 20/200 or better in 23 (67.7%) eyes. Final visual acuity of 20/200 or better had no significant relationship with the site, size, or type of the IRFB or with the interval from trauma to surgery.

CONCLUSION

Despite the complexity of surgical management of IRFBs, anatomic and visual outcomes of vitreoretinal surgery in these cases are generally good. The appropriate route of removal may be determined by the type, size, and site of the IRFB. Removal of magnetic IRFBs using external magnets versus intraocular forceps seems to entail comparable results.

摘要

目的

报告视网膜内异物(IRFB)眼的临床特征,并评估这些眼手术治疗的结果。

方法

回顾33例IRFB患者34只眼的医院记录。所有眼均行玻璃体切割术,使用眼内镊或通过磁性取出法取出异物。

结果

所有患者均为男性,平均年龄28±12.3岁,平均随访时间24.5±2.3个月。29例(85.3%)的IRFB为铁磁性,13只眼(38.4%)使用外部磁铁取出,21只眼(61.6%)使用眼内镊取出。7只眼(20.6%)在手术前围绕IRFB进行了激光光凝。术后8只眼(23.5%)出现黄斑皱襞和瘢痕,12只眼(35.3%)在巩膜切开术后形成视网膜裂孔。最终视力在12只眼(35.3%)中为20/40或更好,在23只眼(67.7%)中为20/200或更好。最终视力20/200或更好与IRFB的部位、大小或类型,以及外伤至手术的间隔时间均无显著关系。

结论

尽管IRFB的手术治疗复杂,但这些病例玻璃体视网膜手术的解剖和视觉效果总体良好。合适的取出途径可根据IRFB的类型、大小和部位来确定。使用外部磁铁与眼内镊取出磁性IRFB的效果似乎相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b54d/3957039/f0c027153652/JOVR-08-330f1.jpg

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