Gopal L, Banker A S, Deb N, Badrinath S S, Sharma T, Parikh S N, Shanmugham M P, Bhende P S, Das D, Mukesh B N
Department of Vitreoretinal Diseases, Sankara Nethralaya, Medical and Vision Research Foundations, India.
Retina. 1998;18(3):213-20. doi: 10.1097/00006982-199803000-00004.
To describe the results of management of glass intraocular foreign bodies (IOFBs).
A total of 51 eyes of 43 patients that sustained penetrating injury with glass IOFB were studied retrospectively. A total of 23.5% had IOFB only in the anterior segment; the rest had IOFB in the posterior segment alone or in both the anterior and posterior segments. Six eyes were followed conservatively despite IOFB in a functional eye. Removal of IOFB was combined with repair of retinal detachment (where present) using internal tamponade with gas or silicone oil or buckle.
After a mean follow-up of 16.8 months, 66.7% of eyes recovered better than 6/60 (20/200) vision and 75.6% had attached retina. On univariate analysis, scleral entry wound, posterior segment IOFB, larger size of IOFB, and retinal damage were found to be associated with poor anatomic outcome. Lower presenting visual acuity, hyphema, retinal damage, subretinal hemorrhage, detached retina, and larger IOFB were associated with a poor functional result. Multivariate analysis identified retinal damage caused by the foreign body as the only factor significantly associated with poor anatomic as well as functional outcome.
Glass IOFBs are caused in a majority of cases by blast injury. Bilaterality is not uncommon. Presence of retinal damage is predictive of poor functional and anatomic results. Overall results are modest with modern vitreoretinal surgical techniques.
描述玻璃体内眼内异物（IOFBs）的治疗结果。
回顾性研究43例因玻璃体内眼内异物导致穿透伤的51只眼。23.5%的患者仅前段有眼内异物；其余患者眼内异物仅位于后段或同时存在于前段和后段。尽管有6只眼存在功能良好的眼内异物，但仍进行了保守随访。眼内异物取出术联合视网膜脱离修复术（如有），采用气体或硅油或巩膜扣带进行眼内填充。
平均随访16.8个月后，66.7%的患眼视力恢复至优于6/60（20/200），75.6%的患眼视网膜复位。单因素分析发现，巩膜伤口、后段眼内异物、眼内异物较大以及视网膜损伤与不良的解剖学结果相关。初始视力较低、前房积血、视网膜损伤、视网膜下出血、视网膜脱离以及眼内异物较大与不良的功能结果相关。多因素分析确定异物导致的视网膜损伤是与不良解剖学和功能结果显著相关的唯一因素。
玻璃体内眼内异物多数由爆炸伤引起。双侧受累并不少见。视网膜损伤的存在预示着功能和解剖学结果不佳。采用现代玻璃体视网膜手术技术，总体结果尚可。
