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取出角膜金属异物和锈环的改良方法

             

摘要

•AIM:To compare the effectiveness and outcome of two different methods for removing metal foreign bodies and rust rings from cornea. •METHODS:Forty outpatients with cornea metal foreign body injuries were recruited. They were divided into two groups according to the methods used to remove the foreign body and the rust ring ( group 1 using needle +forceps; group 2 using needle only ) . The effectiveness and outcome were compared across groups in term of the duration of the surgery, pain scores, and the recovery of epithelial damage, as well as the integrity of the removed rust rings, which was associated with the difficulty of the surgery.•RESULTS: In group 1, rust rings were removed readily in one piece in one or two attempts, while in group 2, the rings were broken into several pieces before they were totally removed. The averaged surgery duration for patients in group 1 was 1. 9min(37. 3%) shorter than that in group 2 (P<0. 001). The pain score of group 1 was also significantly lower than that of group 2 during and 1d after the surgery. In group 1, a full recovery of the corneal epithelium, indicated by negative fluorescent staining, was seen in 80% of cases 1d after the surgery, while in group 2, this was only 55%.•CONCLUSION: The method in group 1 is easier to perform and results in better outcomes than the conventional method in group 2 for removing the rust rings formed by corneal metal foreign bodies.%目的:比较用两种方法取出角膜金属异物和锈环的效果。方法:将40例门诊角膜金属异物患者分为两组。第1组(20例)采用注射针头配合镊子取出异物和锈环;第2组(20例)采用注射针头取出异物和锈环。将两组间操作时间长短、患者疼痛程度、角膜上皮损伤修复时间和取出锈环的完整性进行比较。结果:第1组患者的角膜锈环经过一至两次尝试后完整取出;而在第2组中,锈环往往破碎成数块之后才能全部取出。第1组患者的平均手术时间较第2组短1.9 min (37.3%)(P<0.001)。第1组患者术中和术后1d的疼痛评分也明显低于第2组。第1组患者80%的眼术后1 d角膜上皮细胞已修复,荧光染色呈阴性;而在第2组,同期只有55%的眼角膜荧光染色呈阴性。结论:第1组取出角膜金属异物和锈环所采用的方法较第2组的传统方法更容易操作且疗效更好。

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