摘要
目的了解眼表铁屑损伤的临床特点。方法于2014年3月至2015年1月在山西医科大学第一医院眼科连续搜集诊治的眼表铁屑损伤患者36例（37只眼），总结其临床特征。结果伤者全部为男性，18～60岁，平均年龄（38．2±15．5）岁，右眼居多（右眼21只，左眼14只，双眼1例），常发生在使用电动工具切割、打磨金属过程中，受伤当时无明显不适，或仅有短暂的酸涩感，12至24h后始觉明显异物感、畏光、流泪、视力下降前来就诊，查体可见异物嵌顿于角膜基质浅层（35只眼）或者巩膜表面结蹄组织内（2只眼），异物周围有棕黄色浸润灶，角膜开始软化，部分病例出现角膜内皮皱褶，经剔除铁屑异物和药物治疗后，3例嵌顿于瞳孔中心者自觉视力较受伤前有下降；4例嵌顿于瞳孔区者有眩光现象；其余病例自觉视功能较受伤前无明显变化。查体可见2例铁屑嵌顿于巩膜表面者可见细小结膜瘢痕，35例嵌顿于角膜及角巩膜缘者可见范围不等的角膜薄翳。结论眼表铁屑损伤是眼科常见的一类眼表损害，常发生在机械切割、打磨金属过程中，受伤当时伤眼并无特殊不适，或仅有短暂的酸涩感。经12至24h左右，伤眼自觉明显异物感、畏光、流泪、视力下降。治疗时剧除眼表异物，刮取角膜浸润环，使用药物抗炎、促进组织修复。眼表铁屑损伤经治疗后可以获得满意的结果。
Objective To analyze the clinical characteristic of ocular surface iron scrap injury. Methods A retrospective study. Thirty-six patients （37 eyes） with ocular surface injury of iron scrap were collected in our hospital and their clinical characteristics were summarized. Results Patients were all males, 18-60 years old, the right eyes were more often be injured than left eyes （21：14 eyes）. Injuries often occurred in the process of cutting or grinding, no special discomfort just after injury and the next day felt obvious discomfort： foreign body sensation; photophobia; and tears. The iron scraps from ocular surface were removed and anti inflammation and promoting healing of ocu- lar surface eye drop were used. After the treatment, 3 patients appeared decreased vision, 4 cases with glare, the rest was no obvious change compared with before injury. Corneal or conjunctival mini superficial scarring were seen by slit lamp microscope examination. Conclusions Ocular sur- face iron scrap injury is a common damages, often occur in the process of cutting or grinding, no special discomfort just after injury, and the next day feel obvious discomfort： foreign body sensa- tion; photophobia; and tears. Taking out the iron scrap from ocular surface, using drugs diminish in- flammation, promoting healing of ocular surface. The treatment can obtain satisfactory results.
出处
《中国实用眼科杂志》
2016年第3期289-291,共3页
Chinese Journal of Practical Ophthalmology
关键词
铁屑
损伤
眼表
临床特点
Iron scrap
Injury
Ocular surface
The clinical characteristic
