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眼内窥镜在开放性眼外伤合并睫状体异物取出术中的应用价值。

Value of Ocular Endoscopy in Extraction of Intraocular Foreign Bodies of Cilia in Patients with Open Ocular Trauma.

机构信息

Soochow University Affiliated Eye Hospital, Soochow, Jiangsu, China (mainland).

Beijing Tongren Hospital Affiliated to Capital Medical University Eye Center, Beijing, China (mainland).

出版信息

Med Sci Monit. 2021 Dec 29;27:e932970. doi: 10.12659/MSM.932970.

DOI:10.12659/MSM.932970
PMID:34963679
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8721989/
Abstract

BACKGROUND The aim of this study was to analyze the value of ocular endoscopy in detecting and extracting intraocular cilia in patients with ocular trauma. MATERIAL AND METHODS We retrospectively analyzed data on identification and extraction of 46 intraocular cilia in 16 eyes with open-globe injury during endoscope-assisted vitrectomy. RESULTS A total of the 16 patients with open-globe injury were operated on from September 2002 to June 2019. The cornea in 14 eyes was cloudy. Two eyes had endophthalmitis and 13 eyes had retinal detachment. A total of 46 cilia were extracted through direct observation under the ocular endoscope during vitrectomy 1 to 68 weeks after injury. The number of cilia per eye varied from 1 to 10. Most of the cilia were located in or near the wound. Postoperative IOP was normal in 14 patients. The follow-up after surgery showed hypotony in only 2 eyes (7.2 and 5.8 mmHg, respectively). Compared with preoperative intraocular pressure, there was a statistically significant difference. The postoperative visual acuity improved in 12 eyes and remained unchanged in 3 eyes. The vision after surgery was significantly improved compared with that before surgery (P=0.006). The intraocular pressure increased significantly after operation (P<0.001). And no glaucoma or retinal detachment or endophthalmitis was found. No eyes needed additional vitreous surgery. CONCLUSIONS Ocular endoscopy allows surgeons to detect intraocular cilia that were no undetected by CT or B-ultrasound preoperatively in time and to extract them effectively. It improves performance of vitrectomy in the presence of a cloudy cornea and also prevents exogenous endophthalmitis. The vision of patients with ocular trauma was improved.

摘要

背景

本研究旨在分析眼内窥镜在检测和提取眼外伤患者眼内睫毛中的价值。

材料与方法

我们回顾性分析了 16 例眼内窥镜辅助玻璃体切除术中发现和提取 46 例眼内睫毛的资料。

结果

共 16 例开放性眼外伤患者于 2002 年 9 月至 2019 年 6 月手术。14 例患者角膜混浊,2 例眼内炎,13 例视网膜脱离。在玻璃体切除术中,通过眼内窥镜直接观察,在受伤后 1 至 68 周共取出 46 根睫毛。每只眼的睫毛数从 1 到 10 根不等。大多数睫毛位于伤口内或附近。术后 14 例患者眼压正常。术后随访仅 2 眼(分别为 7.2mmHg 和 5.8mmHg)出现低眼压。与术前眼压相比,差异有统计学意义。术后视力提高 12 例,无变化 3 例。术后视力明显优于术前(P=0.006)。术后眼压明显升高(P<0.001)。未发现青光眼、视网膜脱离或眼内炎。无需行额外玻璃体手术。

结论

眼内窥镜能及时发现术前 CT 或 B 超未发现的眼内睫毛,并有效提取,提高混浊角膜下玻璃体切除手术的效果,预防外源性眼内炎的发生。眼外伤患者的视力得到改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5171/8721989/1583359e587c/medscimonit-27-e932970-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5171/8721989/6143a241f17c/medscimonit-27-e932970-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5171/8721989/1583359e587c/medscimonit-27-e932970-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5171/8721989/6143a241f17c/medscimonit-27-e932970-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5171/8721989/1583359e587c/medscimonit-27-e932970-g002.jpg

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本文引用的文献

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Clin Ophthalmol. 2021 Jan 5;14:4587-4593. doi: 10.2147/OPTH.S290619. eCollection 2020.
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Commentary: Ocular endoscopy: An eye into the eye.评论:眼内镜检查:深入眼内的观察手段。
Indian J Ophthalmol. 2021 Jan;69(1):25-26. doi: 10.4103/ijo.IJO_1966_20.
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Intraocular endoscopy: A review.眼内内窥镜检查:综述
Indian J Ophthalmol. 2021 Jan;69(1):14-25. doi: 10.4103/ijo.IJO_1029_20.
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Endoscopic vitreoretinal surgery: Review of current applications and future trends.内窥镜玻璃体视网膜手术:当前应用与未来趋势回顾。
Surv Ophthalmol. 2021 Mar-Apr;66(2):198-212. doi: 10.1016/j.survophthal.2020.11.004. Epub 2020 Dec 3.
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Epidemiology, Clinical Characteristics, and Visual Outcomes of Patients with Intraocular Foreign Bodies in Southwest China: A 10-Year Review.中国西南地区眼内异物患者的流行病学、临床特征和视觉结局:一项 10 年回顾。
Ophthalmic Res. 2021;64(3):494-502. doi: 10.1159/000513043. Epub 2020 Nov 13.
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Ocular siderosis: a misdiagnosed cause of visual loss due to ferrous intraocular foreign bodies-epidemiology, pathogenesis, clinical signs, imaging and available treatment options.眼内铁质沉着症:因眼内铁质异物导致视力丧失的被误诊病因——流行病学、发病机制、临床症状、影像学表现及现有治疗选择。
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