多发性角膜深层异物取出临床观察

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1、多发性角膜深层异物取出临床观察作者：李仁芳，熊斌，曹泽刚，沈华墨【摘要】　　探讨多发性角膜深层异物取出方法。方法：本组患者42例45眼，其中异物穿透角膜全层并部分伸入前房者13例。磁性异物2例，非磁性异物36例，混合性异物4例。未穿透角膜者可用显微镊直接拔出，或作一浅层角膜切开后拔出。穿透角膜者，充分缩瞳，以15°角膜穿刺刀作前房穿刺，确保无房水外漏，黏弹剂自穿刺口注入前房并加深其深度，以顶退的方式自角膜面将异物稍加送出，露出异物尾端，此时不急以拔除，而以相同的手法处理其余异物，待所有异物尾端均露出角膜面后

2、，再以多个有齿镊同时将异物取出。结果：45眼异物42眼顺利取出，3眼因初始取出经验不足导致术后并发性白内障，8眼合并虹膜炎，10眼发生角膜炎均为伤后超过1wk方来就诊者。在伤后3d内及时就诊的患者，术后视力改善几率明显高于1wk者。结论：对于多发性深层角膜异物，尤其是多发性穿透性角膜异物的取出，应争取尽早就诊手术，手术设计应以保护晶状体为前提，尽量减少手术并发症的发生。【关键词】多发性；角膜深层；异物；手术治疗　　AbstractAIM:Todiscussthemethodofmultiplecornea

3、indepthforeignbodiesremoval.METHOD:Thisgroupofpatient942examples(45eyes),theforeignbodiespenetrationcorneaentirelevelandthepartenteranteriorchamber13examples.Thepatientsareusedsedativedrugsalloverandreducedthepupilfully.Use15stabknifetoperformparacentesis

4、ofanteriorchambertoensurethereisnoleakageofaqueoushumor.Viscoelasticsubstancesareinjectedfromthepuncturesiteintotheanteriorchamberandthenenhanceitsdepth.UseSmoothforcepstodrawsbackfromthecorneasurfacetheforeignbodiestosendoutslightly,revealsendtheforeignbo

5、dies,thistimenotanxiouslywipesout,butprocessesotherforeignbodiesusingthetechniqueofsame,aftertreatingendallforeignbodiesrevealsthecorneasurface,bythesametime,usethetoothforcepstotakeouttheforeignbodies.RESULTS:Fortyfiveforeignbodies42takenoutsmoothly,3eye

6、sthelightconcurrencycataractbecauseinsufficientlyexperienced,8eyesuveitises.10eyeskeratitisaresurpassesthe1weektoseeingthedoctor.Afterthewoundin3daysthepromptseeingthedoctor'spatient,theVisionimprovementprobabilityishigherthan1weekobviously.CONCLUSION:Them

7、ultipleindepthcornealforeignbody,especiallymultiplepenetrabilitycornealforeignbody'sextraction,Shouldreceiveamedicalexaminationassoonaspossibleandthesurgery,thesurgerydesignsshould9takeprotectthelensasthepremise,reducesthesurgerycomplicationasfaraspossibl

8、e.　　KEYWORDS:multiple;corneaindepth;foreignbodies;thesurgerytreats　　0引言角膜深层异物是眼外伤中的常见病，而多发性角膜深层异物多见于多刺形植物及爆炸伤，角膜异物伤分为磁性和非磁性，角膜深层磁性异物应用磁铁容易取出，而角膜深层非磁性异物，尤其是多发性深层角膜异物取出则有一定困难。取出不当，易造成感染、角膜及晶状体的损伤而影响视力。我地区盛产板栗