Ahmadieh H, Sajjadi H, Azarmina M, Soheilian M, Baharivand N
Department of Ophthalmology, Labbafinejad Medical Center/Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Retina. 1994;14(5):397-403. doi: 10.1097/00006982-199414050-00002.
To identify the clinical features in eyes with intraretinal foreign bodies (IRFBs) and evaluate the results of surgical management in these cases.
The records of 75 patients (76 eyes) with IRFBs were retrospectively reviewed. All eyes underwent vitrectomy. The IRFBs were removed with intraocular forceps in 45 eyes (59.2%) and by magnetic extraction in 31 eyes (40.8%), either through pars plana sclerotomy or through the sclera over the IRFB after precise localization. Laser photocoagulation or cryotherapy was performed around the IRFB before surgery in 38 eyes.
The average follow-up period was 34 months. Of the 75 patients, 46 (61.3%) were injured at war. The IRFBs were metallic in 71 (93.4%) eyes. Of these, 59 (83%) were ferromagnetic. In these 76 eyes, final visual acuity was 20/15-20/40 in 37 (48.6%), and 20/50-20/200 in another 10 (13%). In 19 eyes (25%), partial or total retinal detachment was present at the final follow-up examination.
Surgical management of IRFBs is a complicated procedure. The appropriate route of removal may be determined by the type and site of the embedded IRFB. Performance of a meticulous vitrectomy is mandatory, and an attempt should be made to minimize the rate of iatrogenic peripleral retinal breaks. Preoperative retinopexy around the site of the embedded foreign body is recommended, if possible, to reduce the risk of retinal detachment. The prognosis in eyes with IRFBs and rhegmatogenous retinal detachment is guarded.
确定视网膜内异物（IRFBs）眼的临床特征，并评估这些病例的手术治疗结果。
回顾性分析75例（76只眼）IRFBs患者的病历。所有患眼均接受了玻璃体切除术。45只眼（59.2%）用眼科镊取出IRFBs，31只眼（40.8%）通过磁体吸出，均在精确定位后经扁平部巩膜切口或经IRFB上方的巩膜取出。38只眼在手术前围绕IRFB进行了激光光凝或冷冻治疗。
平均随访期为34个月。75例患者中，46例（61.3%）在战争中受伤。71只眼（93.4%）的IRFBs为金属性。其中，59只眼（83%）为铁磁性。在这76只眼中，37只眼（48.6%）的最终视力为20/15 - 20/40，另有10只眼（13%）为20/50 - 20/200。在最后一次随访检查时，19只眼（25%）存在部分或完全视网膜脱离。
IRFBs的手术治疗是一个复杂的过程。合适的取出途径可根据嵌入IRFB的类型和部位来确定。必须进行细致的玻璃体切除术，并应尽量降低医源性周边视网膜裂孔的发生率。如果可能，建议在嵌入异物部位周围进行术前视网膜固定术，以降低视网膜脱离的风险。IRFBs合并孔源性视网膜脱离的眼预后不佳。
