The Analysis Of Operation Style Selection And Complications Of Introcular Foreign Body

Intraocular foreign bodies is that of foreign body penetrating eye wall,in terms of retention eyes.Intraocular foreign bodies is a complex eye trauma,many other organizations with eye injury. Open eye injuries accounted for 18%-40%,especially from young people or vulnerable adults blinding.Foreign body intraocular foreign body in addition to the damage of mechanical injury,there is inflammation,infections and certain foreign bodies caused by the chemical toxicity and damage,serious eye injury affected the visual function.According to reports around the surgical vision in the following 0.05(blindly),60%above;Foreign body removal surgery are still blindly 35%to 50%,and one 1/3 light perception. After surgery to maintain or restore normal vision to only about 10%.But surgery makes 6%to 10%of patients in a temporary or permanent decline in eyesight.Foreign bodies in the damage of the ocular foreign bodies and the size,composition and chemical nature,location retention time and the closely related complications.Therefore,intraocular foreign body injury preven- tion and timely treatment to correct it is very important,in principle,for all of intraocular foreign body is the need for early diagnosis and timely removal,eyeball to protect,maintain and restore eyesight.Intraocular foreign bodies sometimes history and performance typical happen occasionally misdiagnosis and missed diagnosis and treatment delays.Because of intraocular foreign body from the trauma caused by most patients at the same time with or scleral and corneal perforation injuries,traumatic cataract, vitreous hemorrhage,including turbidity,ocular inflammation, such as machines,with slit lamp microscope glasses and check seized by the eyes of the restrictions,according to the specific conditions of magnetic test method electric Induction test, ultrasound,X-ray inspection,X-ray,CT,MRI and chemical analysis methods to understand the special examination of the nature of the injury,the situation within the eye.Intraocular foreign body extraction is not for the purpose of intraocular foreign body,but simply a means of treatment.The purpose of the treatment is to restore or preserve vision.Therefore,each with a foreign body in the exact position must be carefully surgery to reduce the trauma of surgery,to create conditions for the restoration of eyesight.In this paper,our hospital from June 1996 to June 2006 101 cases(104)were studied retrospectively,in different locations within the foreign body with a different method, the time of surgery,foreign body in nature,ocular foreign body of the extent of injuries,complications,surgical methods and postoperative visual acuity Analysis of the relationship.Intraocular foreign bodies with a view to the diagnosis and treatment to help.Objective This study is proposed to discuss the therapeutic effects and complications of different operative methods and influential factors of therapeutic effects when trea-ting intraocular foreign bodies.Method We collected 101 cases(104eyes)of ocular perforation patients combined with intraocular foreign bodies. We had different operative methods according to locations of foreign bodies,then analyzed the relations of operation time,the severity of ocular trauma and surgical methods with postoperative visual acuity.Results 1.Removal of foreign body achieved in 101 eyes and 3 eyeballs extirpation were done because of the severity of ocular trauma.2.101 cases(104eyes),preoperative vision >_ 0.01 46cases(44.23%).Postoperative visual acuity >_ 0.01 71cases (68.27%),the best visual acuity is 1.0.Acuity of 76 cases elevated (73.08%),vision unchanged 14(13.46%),decreased visual acuity 14(13.46%).The rates of visual acuity≥0.5,0.2-0.5,0.05-0.1, numerus digitorum are respectively 30.77%,7.69%,23.08%and 38.46%.49 eyes were followed up for 3 months to 25 months.The vision of 9 eyes is below 0.01(9/49,18.37%),16 eyes 0.01 to 0.09 (16/49,32.65%),24 eyes above 0.1(24/49,49.00%).3.Patients were divided into 2 groups according to vision below or above and equal to 0.01.The shorter operation time achieved,the better postoperative visual acuity observed.And there is significant difference.4.There is significant difference of the visual acuity between the endophthalmitis group,TRD group and other groups. As a result of different severity of the injury,other groups obtained better vision.5.In this study,different surgical methods of scleral incision direct admission of magnetic,the flatness of the ciliary body indirect admission of magnetic,vitreous surgery intraocular foreign body extraction operation,the lens foreign body extraction and intraocular lens implantation,and other operations had no significant difference.6.Postoperative complications: after anterior segment operation pupil deformation occurred in 5 eyes,but the vision was not effected.Then no treatment was given. Lens posterior capsular opacification occurred in 3 eyes,YAG laser capsulotomy operated and vision improved.Proliferative vitreoretinopathy,retinal detachment observed in 19 eyes.We did vitrectomy to them again,filled with silicone oil or gas,and 15 eyes succeeded.6 eyes in endophthalmitis group undergone vitrectomy again,four had better vision,2 had recurrent retinal detachment, eye atrophy and vision loss.Conclusions:1.Vision recovery is related to the severity of trauma and complications.The more serious the complications occurd and the worse postoperative visual acuity achieved.2.The operation of intraocular foreign body,we found the shorter surgical time obtained,the better the vision achieved.The difference is significant.3.Foreign bodies located in cornea, anterior sclera,anterior chamber,iris face,former angle,posterior chamber and there is no traumatic cataract,vitreous hemorrhage organization or retinal detachment,we did simply wall incision surgery.4.Foreign body in lens,we did lens extraction and intraocular lens implantation.5.Foreign bodies with small or medium-large size located in the posterior segment or near the equator in the eyeball wall and there was no vitreous hemorrhage organization,retinal detachment or intraocular infec-tions,we did direct extraction through scleral incision.6.Magnetic foreign bodies shorter than 2mm floating in the vitreous cavity and in the optic nerve head,or around the macular retina surface without adhesion or package,transparent refractive strom,we did incision through the orbiculus ciliaris and extraction with indirect magnetic force method.7.Vitreous surgery is suitable for intraocular foreign bodies removal.During the operation,surgical instruments can approach all of the non-magnetic foreign bodies in the optic nerve head and under posterior pole retina or magnetic foreign bodies incarcerated in and around the posterior pole retinal surface. Vitreous surgery is also suitable for certain magnetic foreign bodies removal in the cases of vitreous hemorrhage or serious turbidity and for phakic lens with large foreign bodies.8.Master indications,the surgeries effect had no obvious differences.9.Postoperative follow-up can reduce complications to the minimum.