Objective To evaluate the therapeutic effect of vitreo-retinal surgery on oclular siderosis. Methods The clinical data of 22 patinets (22 eyes) with ocular siderosis due to the magnetic foreign body at intraocular postsegment were retrospectively analyzed. The patients aged from 6 to 54 years (average 40 years), including 21 males and 1 femal. The duration of the magnetic foreign body remained in the eye lasted for 1 month to 20 years. The preoperative best corrected visual acuity (BCVA) was ＜0.01 in 15 eyes, 0.01-0.15 in 5 eyes and 0.1-0.2 in 2 eyes. There was Intra-vitreous foreign body in 18 eyes and ocular wall embedded foreign body in 4 eyes; intraocular foreign body (IOFB) combined with cataract in 18 eyes; combined with retinal detachment in 3 eyes; scleral buckling combined with silicon oil filled in 12 eyes and C3F8 filled in 7 eyes. Cataract extraction was performed in 12 eyes, and 2 eyes underwent filtrating surgery. Results The IOFB was successfully removed by one-off surgery in 22 eyes. BCVA increased in 20 eyes (90.9％) and kept unchanged in 2 eyes (9.1%), including＜0.1 in 7 eyes, 0.1-0.4 in 8 eyes, and 0.5-1.0 in 7 eyes. Operative complications involved retinal holes with retinal detachment in 2 eyes and vitreous haemorrhage secondary to enlarge sclera incision in 2 eyes. Postoperative complications included secondary cataract in 4 eyes, retinal detachment due to silicon oil removal 3 months after submacular removal of foreign body in 1 eye, and retinal detachment 7 days after C3F8 filling in 1 eye; the latter two eyes had reattached retina after another silicon oil filling. At the end of the follow-up period, retina reattached in 22 eyes. Conclusion Advanced modern vireoretinal operation is effective on oclular siderosis, which can avoid the release of Fe+ and improve the patientsprime; visual function.
Objective To observe the clinical characteristics of severe ocular detonator explosive injuries and to evaluate the therapeutic effects of vitrectomy on it. Methods Clinical data of 37 consecutive patients (65 eyes) with severe ocular detonator explosive injuries were retrospectively analyzed. The patients included 36 males and 1 female with the average age of 28.6 years. The biocular injuriy was in 31 cases (83.8 %), and one-eyed injury was in 6 cases (16.2%). A total of 48 eyes had severe explosive injury. The visual acuity was no light perception in 9 eyes in which 3 eyeballs were obviously atrophic, light perception in 28 eyes, hand moving in 4 eyes, and counting finger/33 cm in 7 eyes. Vitrectomy was performed on 46 eyes, in which 41 had severe ocular explosive injury. There were no vitreous surgery indications in 13 eyes of 19 eyes didnprime;t undergo surgery; the other 6 eyes didnprime;t undergo surgery due to the atrophic eyeballs or economic reasons. The treating time after trauma was within 1 week in 7 patients (18.9%), 1 week to 1 month in 13 (35.2%), and more than 1 month in 17 (45.9%). The follow-up duration lasted 6 months to 2 years after operation with the average of 8.6 months. Results In 65 eyes, the occupation ratio of conjunctival foreign bodies was 66.2%; corneal foreign bodies was 46.2%; vitreous hemorrhage was 70.8%; intraocular foreign bodies (IOFB) was 69.2%; retinal shocking injury or optic nerve blasting injury was 56.9%. The visual acuity improved in 33 eyes, remained unchanged in 25 eyes, and decreased in 7 eyes. In 46 eyes which had undergone vitrectomy, IOFB injuries was in 35 eyes (76.1%); the visual acuity increased in 26 eyes (59.5%), remained unchanged in 13 eyes (28.3%), and didnprime;t cure in 7 eyes (15.2%) in which 2 eyes underwent ocular enucleation and 5 eyes were atrophic. The increasing rate of visual acuity in the patients who accepted the treatment more than 1 month after injury was low. The occupation ratio of monocular blindness was 51.4% and biocular blind was 8.1%. Conclusions Most of severe ocular explosive injuries by detonator are with IOFB. causes of the high blinding rate are late treatment and serious injury. Strengthening the diagnosis and treatment of retinal shock and optic nerve blast, and performing vitrectomy as soon as possible can improve prognositc visual function of injured eyes.
目的 对上消化道异物的诊治手段及结果进行阶段总结，方便今后诊治手段的选择。方法 对1999~2006年甘肃省康泰医院收治的75例上消化道异物患者的诊断及治疗过程进行回顾性研究。结果 本组病例经保守治疗异物自行排出42例，内镜取出8例，外科手术取出25例，均取得了满意的疗效，住院期间未出现严重并发症。结论 上消化道异物的治疗措施，应依照异物具体情况选择，推荐内镜治疗为首选治疗方法。
【摘要】 目的 探索显微眼内窥镜在后段眼内异物取出及玻璃体切除术中的应用。 方法 将2005年7月-2006年3月38例眼内异物患者分为试验组（15例）及对照组（23例）。试验组采用显微眼内窥镜下完成对外伤性视网膜玻璃体病变等的处理及眼内异物的取出；对照组采用显微镜直视下行常规玻璃体切割及眼内异物取出术。 结果 试验组术后角膜透明度及眼压恢复、视力提高及视网膜复位等情况均优于对照组；异物取出情况、手术时间和并发症两组无差异。 结论 在观察困难或异物处于极周边时应用显微眼内窥镜，能够在手术中直接取出眼内各个部位异物，及时发现视网膜裂孔并同时行抗青光眼手术，减少对角膜材料的依赖和对角膜的损伤，为及时、准确和安全地手术提供了条件。【Abstract】 Objective To investigate the application of the intraocular micro-endoscope in extracting intraocular foreign bodies (IOFB) and vitrectomy. Methods A total of 38 patients with IOFB from July 2005 to March 2006 were divided into a trial group (15 patients) and control group (23 patients). The treatment for traumatic retinal vitreous lesions and extraction of IOFB were performed under the intraocular micro-endoscope in the trial group; while the conventional vitrectomy and IOFB extraction were performed under the microscope in the control group. Results The degree of corneal recovery, improvement of intraocular pressure, visual acuity, and retinal reattachment were better in the trial group than that in the control group. There was no difference in removal of IOFB, surgical time and complications between the two groups. Conclusion In patients with intraocular foreign bodies and cloudy cornea or other conditions that made the observation difficult, intraocular micro-endoscope is a useful convenience without relying on donated cornea. The practice made the judge of size, location and the distance more and more accurate through the monitor.