25G微创玻璃体切除术治疗眼内异物的疗效及术后视力的影响因素分析
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Outcomes and prognostic factors of 25G minimally invasive vitrectomy for intraocular foreign body
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    摘要:

    目的:探讨经25G微创玻璃体切除手术(PPV)治疗的眼内异物的临床特征及疗效,分析术后视力的影响因素。

    方法:收集西南医科大学附属医院眼科2016-01-01/2019-01-01以眼内异物并行25G微创玻璃体切除手术治疗的患者105例105眼,对患者眼内异物的临床特征、PPV的疗效和最佳矫正视力(BCVA)等情况进行回顾性研究并统计分析术后视力的影响因素。

    结果:患者105例中以中青年男性居多,多来自于乡镇。异物类型以金属常见,共计62眼(59.0%),主要由Ⅰ区进入眼内(78眼, 74.3%)。术中异物取出率100%。术前BCVA≥0.1的患者17眼,BCVA<0.1者88眼; 术后BCVA≥0.1患者43眼,BCVA<0.1患者62眼,术后BCVA较术前 BCVA 有提高(P<0.05)。经多因素Logistic回归分析,术前较差的BCVA、视网膜脱离和眼内炎是术后视力较差的独立危险因素。

    结论:25G微创玻璃体切除手术可以改善大多数眼内异物患者视力。术前较差的BCVA、合并视网膜脱离和眼内炎是术后视力较差的重要危险因素。

    Abstract:

    AIM:To explore clinical characteristics, outcomes and prognostic factors for cases with intraocular foreign bodies(IFB)and treated with 25G minimally invasive vitrectomy(PPV).

    METHODS: Patients traumatized with retained IFB and treated with PPV were retrospectively collected from the Department of Ophthalmology, Affiliated Hospital of Southwest Medical University from 2016-1-1 to 2019-1-1. The clinical records including general condition, time and cause of injury, locations andsize of IFBs, comorbidities, and best corrected visual acuity(BCVA)were reviewed and statistical analyzed.

    RESULTS: Among the 105 patients, most of them are middle-aged and young men, mostly from townships. The nature of IFB was mainly metals(62 cases, 59.0%). The entrance of IFB of 78 cases(74.3%)located at Zone I of the eye. There were 17 patients with BCVA≥0.1 before surgery, 88 patients with BCVA<0.1. And 43 patients gained BCVA≥0.1 after operation, and 62 patients with BCVA<0.1. Postoperative BCVA was significantly improved compared with preoperative BCVA(P<0.05). Through multivariate Logistic regression analysis, poor preoperative BCVA, retinal detachment, and endophthalmitis are risk factors for poor visual prognosis.

    CONCLUSION: PPV for treatment of IFB can achieve a better outcome. The poor prognosis of visual acuity is related to retinal detachment, endophthalmitis, and the position and size of IFB.

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罗云霞,田敏,向小红,等.25G微创玻璃体切除术治疗眼内异物的疗效及术后视力的影响因素分析.国际眼科杂志, 2020,20(5):896-900.

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  • 收稿日期:2020-03-04
  • 最后修改日期:2020-04-16
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  • 在线发布日期: 2020-04-26
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