Neubauer H
Trans Ophthalmol Soc U K (1962). 1979;99(4):502-10.
'Redox processes' and complex biochemical formations offer a simple key to understanding metallotic damage to the eye. Various factors determine the timing and severity of this damage. Siderosis is a process with a chronic course. In a large group of patients with copper-containing foreign bodies the majority showed a more acute course. In the past, the relatively rare cases of chronic chalcosis without fibrotic reactions in the vitreous determined the text book descriptions familiar to our fathers. In our series of 282 cases of copper-containing foreign bodies in the vitreous, the chalcosis took a subacute, acute, or fulminating course in 68 per cent, and only half of the other 32 per cent represented time chronic chalcosis. In 18 per cent the injury was recent and the cellular reaction was only just beginning. Cellular reactions, especially fibrosis, are the chief characteristics of acute chalcosis. Vitrectomy permits the surgical treatment of eyes with severe vitreous fibrosis and retinal detachment, but because these eyes are in the pre-phthisic stage, a fair number of successes is counterbalanced by an increasing number of enucleations.
“氧化还原过程”和复杂的生化结构为理解眼部金属沉着损害提供了一个简单的关键。多种因素决定了这种损害的时间和严重程度。铁锈症是一个病程缓慢的过程。在一大群有含铜异物的患者中，大多数表现出更急性的病程。过去，玻璃体中相对罕见的无纤维化反应的慢性铜质沉着症病例决定了我们父辈熟悉的教科书描述。在我们的282例玻璃体含铜异物病例系列中，68%的铜质沉着症呈亚急性、急性或暴发性病程，另外32%中只有一半表现为慢性铜质沉着症。18%的损伤是近期发生的，细胞反应才刚刚开始。细胞反应，尤其是纤维化，是急性铜质沉着症的主要特征。玻璃体切除术允许对伴有严重玻璃体纤维化和视网膜脱离的眼睛进行手术治疗，但由于这些眼睛处于眼球痨前期，相当数量的成功案例被越来越多的眼球摘除术所抵消。
