Наш опыт эндовитреального удаления внутриглазных инородных тел при выполнении хирургии тяжелых проникающих ранений глаз

Abstract

Purpose. To evaluate efficiency and safety of transvitreal removal of intraocular foreign bodies (IOFB) when performing vitrectomy after penetrating eye injuries. Material and methods. 12 patients (12 eyes) with penetrating ocular trauma with IOFB were included in this study. In 2 eyes, IOFB was removed in our clinic on the same day during an emergency surgical treatment, immediately upon admission of patients: in 10 eyes – delayed. At the time of admission to the Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution, we registered low visual acuity or blindness in all 12 eyes: in 8 eyes – from 0.001 to 0.4; in 4 eyes – from LP to NLP. A standard three-port 25-gauge vitrectomy was performed in all patients, during which IOFB was localized. Results. In all eyes IOFB was correctly removed; in 3 eyes with retinal detachment, it was possible to achieve its total reattachment. In 7 eyes, IOFB removal was performed using intraocular forceps: 5 eyes – through the corneal tunnel – the pupillary zone – posterior capsulorhexis at the stage of phacoaspiration, 2 eyes – through the port; in 3 eyes – with the help of a vitreotom; in one eye – with the help of an magnet through the pupillary zone before implantation of the IOL RSP-3 (Russia), and in one eye – with the help of scleral forceps. Conclusion. The IOFB entry wound in 12 eyes were: corneal – 5 eyes, scleral – 5 eyes, corneoscleral – 2 eyes. In 11 eyes IOFB were metallic (9 magnetic and 2 non-magnetic), in 1 eye – non-metallic. The volume and tactics of vitreoretinal surgery in each case of IOFB removal was determined by the initial severity of eye injuries, size, and location of the IOFB, the degree of secondary trauma to the intraocular structures after their removal during the primary wound repair. Key words: ocular trauma, intraocular foreign body, penetrating eye injury, vitrectomy