铁质和非磁性异物对球内异物伤患者致盲和并发症的影响
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摘要
目的分析93例球内异物伤患者术后并发症和视力恢复的情况,探讨损伤部位、损伤异物与并发症及术后视力恢复的相关性。方法收集2010年1月至2016年1月在我院进行的93例急诊球内异物取出术患者临床资料,重点分析患者伤情、球内异物以及术后1年以上的并发症和最佳矫正视力。结果球内异物伤患者术后致残率15. 05%,致盲率51. 61%,并发症发生率39. 78%;球内异物伤患者术后复致盲与术后并发症密切相关(r=0,P=-0. 429),术后并发症的发生与铁质材质密切相关(r=-0. 589,P=0. 00)。结论对于外伤性异物眼球内损伤患者,应积极处置并遏制并发症发生,特别是铁质异物的患者应及时取出,避免损伤视神经视网膜进而影响视力恢复能力。
Objective To analyze the postoperative complications and visual recovery of 93 patients with intraocular foreign body injury,and to explore the correlation between the damaged part and the damaged foreign body and the complications and postoperative visual recovery.Methods From January 2010 to January 2016,the data of 93 patients in our hospital who underwent emergency intraocular foreign body removal were collected,with emphasis on analyzing the patients' injury situation,intraocular foreign body,complications over one year after surgery and optimal corrected vision. Results The rate of disability was 15. 05%,the rate of blindness was 51. 61%,and the incidence of complications was 39. 78%. Postoperative secondary blindness in patients with intraocular foreign body injury was closely related to postoperative complications( r = 0,P =-0. 429),and postoperative complications were closely related to iron materials( r =-0. 589,P = 0. 00). Conclusion For patients with traumatic ocular foreign body injury,complications should be actively dealt with and prevented,especially those with iron foreign body should be removed in time to avoid damage to the optic nerve and retina,thus affecting the ability of vision recovery.
Objective To analyze the postoperative complications and visual recovery of 93 patients with intraocular foreign body injury,and to explore the correlation between the damaged part and the damaged foreign body and the complications and postoperative visual recovery.Methods From January 2010 to January 2016,the data of 93 patients in our hospital who underwent emergency intraocular foreign body removal were collected,with emphasis on analyzing the patients' injury situation,intraocular foreign body,complications over one year after surgery and optimal corrected vision. Results The rate of disability was 15. 05%,the rate of blindness was 51. 61%,and the incidence of complications was 39. 78%. Postoperative secondary blindness in patients with intraocular foreign body injury was closely related to postoperative complications( r = 0,P =-0. 429),and postoperative complications were closely related to iron materials( r =-0. 589,P = 0. 00). Conclusion For patients with traumatic ocular foreign body injury,complications should be actively dealt with and prevented,especially those with iron foreign body should be removed in time to avoid damage to the optic nerve and retina,thus affecting the ability of vision recovery.
引文
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[22]Tawara A. Transformation and cytotoxicity of iron in siderosisbulbi[J].Invest Ophthalmol Vis Sci,1986,27(2):226-236.
[23]Sun Y,Zheng Y,Wang C,et al. Glutathione depletion induces ferroptosis,autophagy,and premature cell senescence in retinal pigment epithelial cells[J]. Cell Death Dis,2018,9(7):753. doi:10. 1038/s41419-018-0794-4.
[24]Marazita MC,Dugour A,Marquioni-Ramella MD,et al. Oxidative stress-induced premature senescence dysregulates VEGF and CFH expression in retinal pigment epithelial cells:Implications for Age-related Macular Degeneration[J]. Redox Biol,2016,9(7):78-87. doi:10. 1016/j. redox. 2015. 11. 011.
[2]胡海林,王俊芳.球内异物74例手术疗效分析[J].国际眼科杂志,2012,12(9):1726-1728. doi:10. 3969/j. issn. 1672-5123. 2012.09. 37.
[3]Imaizumi M,Matsumoto CS,Yamada K,et al. Eleetmretinographic assessment of early changes in ocular sidemsis[J]. Ophthalmologica,2000,214:354-359. doi:10. 1159/000027520.
[4]高立敬.眶内异物的临床分析及治疗策略探讨[J].中华眼科外伤职业眼病杂志,2015,37(10):795-797. doi:10. 3760/cma. j. issn.2095-1477. 2015. 10. 028.
[5]Sindal MD,Sengupta S,Vasavada D,et al. Retained intraocular iron foreign body presenting with acute retinal necrosis[J]. Indian J Ophthalmol,2017,65(10):1036-1038. doi:10. 4103/ijo. IJO. 363. 17.
[6]王毅,李月月,王巍,等.眶内非金属异物25例临床分析[J].中华眼科杂志,2011,47(8):688-692. doi:10. 3760/cma. j. issn.0412-4081. 2011. 08. 005.
[7]周雅丽,底煜,陈晓隆,等.眶内异物16例分析[J].国际眼科杂志,2012,12(6):1195-1196. doi:10. 3969/j. issn. 1672-5123.2012. 06. 63.
[8]Loporchio D,Mukkamala L,Gorukanti K,et al. Intraocular foreign bodies:a review[J]. Surv Ophthalmol,2016,61(5):582-596. doi:10. 1016/j. survophthal. 2016. 03. 005.
[9]Batman C,Cekic O,Totan Y,et al. Combined phacoemulsification,vitrectomy,foreign-body extraction,and intraocular lens implantation[J]. J Cataract Refract Surg,2000,26(2):254-259. doi:10. 1016/S0886-3350(99)00368-5.
[10]王云霄,姜孝志,姚琳,等.眼内异物及其并发症的临床分析[J].中国实用眼科杂志,2011,9(29):972-974. doi:10. 3760/cma. j. issn. 1006-4443. 2011. 09. 028.
[11]Lit ES,Young LH. Anterior and posterior segment intraocular foreign bodies[J]. Int Ophthalmol Clin,2002,42(3):107-120.
[12]Zhou FY,Qiu KJ,Li HF,et al. Screening on binary Zr-1X(X=Ti,Nb,Mo,Cu,Au,Pd,Ag,Ru,Hf and Bi)alloys with good in vitro cytocompatibility and magnetic resonance imaging compatibility[J]. Acta Biomater,2013,9(12):9578-9587. doi:10. 1016/j. actbio. 2013.07. 035.
[13]Zhu L,Shen P,Lu H,et al. Ocular trauma score in siderosis bulbi with retained intraocular foreign body[J]. Medicine(Baltimore),2015,94(39):e1533. doi:10. 1097/MD. 0000000000001533.
[14]Moisseiev D,Barequet D,Zunz E,et al. Validation of an algorithm for nonmetallic intraocular foreign bodies’composition identification based on computed tomography and magnetic resonance imaging[J].Retina,2015,35(9):1898-1904. doi:10. 1097/IAE.0000000000000556.
[15]Ugarte M,Osborne NN,Brown LA,et al. Iron,zinc,and copper in retinal physiology and disease[J]. Surv Ophthalmol,2013,58(6):585-609. doi:10. 1016/j. survophthal. 2012. 12. 002.
[16]He X,Hahn P,Iacovelli J,Wong R,et al. Iron homeostasis and toxicity in retinal degeneration[J]. Prog Retin Eye Res,2007,26(6):649-673. doi:10. 1016/j. preteyeres. 2007. 07. 004.
[17]Gervasio KA,Weinstock BM,Wu AY. Prognostic value of ocular trauma scores in patients with combined open globe injuries and facial fractures[J]. Am J Ophthalmol,2015,160(5):882-888. doi:10.1016/j. ajo. 2015. 08. 007.
[18]Guler M,Yilmaz T,Yigit M. A case of a retained intralenticular body for two years[J]. Clin Opthalmol,2010,4:955-957. doi:10. 2147/OPTH. S12635.
[19]Cazabon S,Dabbs TR. Intralenticular metallic foreign body[J]. J Cataract Refract Surg,2002,28(12):2233-2234. doi:10. 1016/S0886-3350(02)01431-1.
[20]Essex RW,Yi Q,Charles PG,et al. Post-traumatic endophthalmitis[J]. Ophthalmology,2004,111(11):2015-2022. doi:10. 1016/j.ophtha. 2003. 09. 041.
[21]Dehghani AR,Rezaei L,Salam H,et al. Post traumatic endophthalmitis:incidence and risk factors[J]. Glob J Health Sci,2014,6(6):68-76.doi:10. 5539/gjhs. v6n6p68.
[22]Tawara A. Transformation and cytotoxicity of iron in siderosisbulbi[J].Invest Ophthalmol Vis Sci,1986,27(2):226-236.
[23]Sun Y,Zheng Y,Wang C,et al. Glutathione depletion induces ferroptosis,autophagy,and premature cell senescence in retinal pigment epithelial cells[J]. Cell Death Dis,2018,9(7):753. doi:10. 1038/s41419-018-0794-4.
[24]Marazita MC,Dugour A,Marquioni-Ramella MD,et al. Oxidative stress-induced premature senescence dysregulates VEGF and CFH expression in retinal pigment epithelial cells:Implications for Age-related Macular Degeneration[J]. Redox Biol,2016,9(7):78-87. doi:10. 1016/j. redox. 2015. 11. 011.