Department of Ophthalmology, Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Eur J Ophthalmol. 2021 Jan;31(1):263-270. doi: 10.1177/1120672119885587. Epub 2019 Nov 5.
To analyze the anatomical and functional ophthalmic parameters after the surgical removal of various intraorbital foreign bodies.
A retrospective analysis of medical records was performed featuring detailed history, ophthalmic examination, orbital computed tomographic scans, treatment details, and outcomes. The analyzed anatomical factors included extraocular movements, the position of the eyeball (proptosis, dystopia, and enophthalmos), and fullness of orbital sulci. The functional assessment was based on visual acuity, pupillary reactions, and diplopia. The outcomes were defined as complete, partial, and failure after a minimum follow-up of 1 year.
Of 32 patients, the organic and inorganic intraorbital foreign bodies were surgically removed from 18 (56.25%) and 14 (43.75%) orbits, respectively. At presentation, anatomically the extraocular movement restriction, proptosis/dystopia/enophthalmos, and orbital sulcus fullness were noted in 26 (81.25%), 24 (75%), and 15 (46.88%), respectively. Functionally, diminished visual acuity, diplopia, and pupil abnormalities were seen in 27 (84.38%), 14 (43.75%), and 8 (25%), respectively. After intraorbital foreign body removal at a mean follow-up of 14 months, the improvement of anatomical factors (same sequence) were observed in 8 (30.77%), 20 (83.33%), and 12 (80%), respectively. In functional factors (same sequence), the improvement was noted in none (0%), 13 (92.86%), and 5 (62.5%), respectively. Hence, the majority of patients (n = 20, 62.5%) achieved partial success, while 8 (25%) had complete success. Four (12.5%) had treatment failure despite similar management protocols.
The anatomical outcomes are better than the functional outcomes after surgical removal of the intraorbital foreign bodies. The visual acuity does not improve considerably after the surgical removal of intraorbital foreign bodies. Overall, the wooden intraorbital foreign bodies have poorer anatomical and functional prognosis.
分析不同眼眶内异物手术切除后的解剖和功能眼科参数。
对详细病史、眼科检查、眼眶计算机断层扫描、治疗细节和结果进行回顾性分析。分析的解剖学因素包括眼球运动、眼球位置（突出、偏斜和凹陷）和眶沟饱满度。功能评估基于视力、瞳孔反应和复视。结果定义为至少 1 年随访后完全、部分和失败。
在 32 名患者中，18 只（56.25%）和 14 只（43.75%）眼分别进行了有机和无机眼眶内异物的手术切除。在就诊时，26 只（81.25%）、24 只（75%）和 15 只（46.88%）分别出现眼球运动受限、突出/偏斜/凹陷和眶沟饱满。在功能方面，27 只（84.38%）、14 只（43.75%）和 8 只（25%）分别出现视力减退、复视和瞳孔异常。在眼眶异物切除后平均 14 个月的随访中，观察到解剖学因素（按相同顺序）的改善分别为 8 只（30.77%）、20 只（83.33%）和 12 只（80%）。在功能因素（按相同顺序）中，无改善分别为 0 只（0%）、13 只（92.86%）和 5 只（62.5%）。因此，大多数患者（n=20，62.5%）取得了部分成功，8 例（25%）取得了完全成功。尽管采用了类似的治疗方案，但仍有 4 例（12.5%）治疗失败。
眼眶内异物切除后，解剖学结果优于功能结果。眼球运动、眼球位置和眶沟饱满度在眼眶异物切除后有明显改善。视力在眼眶异物切除后改善不明显。总的来说，木制眼眶内异物的解剖学和功能预后较差。
