Dong Pham Ngoc, Duong Nguyen Thi Nga, Cung Le Xuan, Huong Duong Nguyen Viet, Ngan Nguyen Dinh, Thien Chu Dinh, Quyet Do, Bac Nguyen Duy
Vietnam National Institute of Ophthalmology, Hanoi, Vietnam.
Ho Chi Minh University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.
Open Access Maced J Med Sci. 2019 Dec 20;7(24):4311-4315. doi: 10.3889/oamjms.2019.381. eCollection 2019 Dec 30.
Penetrating ocular trauma with intraocular foreign body is a serious injury often resulting in loss of vision. Anterior chamber foreign bodies account for a considerable portion of all cases of all intraocular foreign bodies (up to 15%); however, they can be missed due to inconspicuous location.
We report two cases of retained intraocular foreign bodies in the iridocorneal angle that was missed at the first ophthalmic examination. They were only discovered when complications occurred, such as corneal edema and increased intraocular pressure. In the case whereby the foreign body was taken out early, corneal damages were reversible. However, in the case whereby the foreign body was taken out late, endothelial damage was irreversible and endothelial transplantation was needed.
Regarding trauma patients, a careful examination should be performed to discover foreign bodies in the iridocorneal angle. If local peripheral corneal edema occurred, attention should be paid to the trauma history and to timely discovery of the foreign body. This will prevent any irreversible corneal damages.
伴有眼内异物的穿透性眼外伤是一种严重损伤，常导致视力丧失。前房异物在所有眼内异物病例中占相当比例（高达15%）；然而，由于位置不明显，它们可能会被漏诊。
我们报告两例虹膜角膜角内眼内异物残留病例，首次眼科检查时均未发现。它们仅在出现并发症时才被发现，如角膜水肿和眼压升高。在异物早期取出的病例中，角膜损伤是可逆的。然而，在异物晚期取出的病例中，内皮损伤是不可逆的，需要进行内皮移植。
对于外伤患者，应仔细检查以发现虹膜角膜角内的异物。如果出现局部周边角膜水肿，应注意外伤史并及时发现异物。这将防止任何不可逆的角膜损伤。
