intraocular foreign body removal

For foreign bodies in the lens, some should be taken out early. For example, some foreign objects are exposed outside the crystal. Early removal facilitates the early closure of the capsule wound and preserves part of the vision of the crystal. Non-magnetic foreign objects such as wood chips and bamboo thorns, because of rapid response, and can be complicated by inflammation, leading to cataracts, should also be taken early. For magnetic foreign objects larger than 2mm, it is advocated that at the time of injury, that is, the electromagnet is sucked out, the faster the removal is taken, the smaller the tissue damage is, the wound is relatively neat, and the closure is easy. But some people think that doing so will aggravate crystal damage. Regardless of the size of the foreign body, anyone with rust should be removed. If the foreign body in the crystal is combined with a rupture of the capsule, the lens is completely turbid, and part of the lens is detached into the anterior chamber or vitreous, early surgery should be performed. At the same time as removing the cataract, the foreign body in the crystal should be removed; if the capsule is intact, unless there is infection or In addition to emergency surgery, acute glaucoma must be waited for 6 to 12 months. At this time, cataracts and foreign bodies should be removed at the same time. Treatment of diseases: ocular trauma Indication Intraocular foreign body removal is suitable for: 1. Foreign matter enters the crystal, but a portion is exposed outside the lens capsule. 2. Incoming foreign bodies combined with inflammatory responders. 3. Magnetic foreign objects larger than 2mm are determined according to the specific conditions in the previous section. Contraindications The foreign body is less than 1mm, the turbidity range is fixed, and the visual acuity is good. Preoperative preparation 1. Slit lamp, ultrasound, X-ray boneless photo examination, localization of foreign bodies, and visual acuity. The foreign matter of the lens can be detected by a stereo method or a reflective method. Due to the shading effect of the foreign matter, it can be seen that there is a black shadow in the crystal, and those located in the equator need to be scattered to see the pupil. The rust deposition is characterized by the accumulation of brownish yellow particles in the epithelial area of the crystal. The copper deposition is mostly under the anterior capsule of the crystal, and there is a sunflower-like turbidity composed of gray edge color, gray or brownish green fine dots. 2. Antibiotic eye drops were taken 24 hours before surgery, 1 time every 2 hours, 1% adrenaline or 1% phenylephrine before the operation room, and the pupil was enlarged to 8mm. 3. Rinse the conjunctival sac three times with saline. Surgical procedure Anesthesia and position Mucosal anesthesia, subconjunctival anesthesia, anesthesia after the ball. Surgical procedure Electromagnet foreign body aspiration (1) Make a limbal incision (according to the position of the foreign body in the crystal), so that the incision, the foreign body, and the magnet head are in a straight line. (2) Using a hand-held electromagnet, the terminal is aimed at the foreign matter in the crystal, so that the foreign matter, the crystal anterior capsule rupture and the electromagnetic head are in a straight line, the current is started, the foreign matter jumps out from the crystal, is attached to the electromagnetic head, is taken out, and immediately advances. Inject 0.1 ml of diluted pilocarpine into the room to reduce the pupil so that the iris seals the anterior capsule of the lens. (3) If the cornea is intact, foreign matter will fall on the surface of the iris after entering the anterior chamber. In principle, once the foreign body has detached from the crystal, the pilocarpine should be injected into the anterior chamber to shorten the pupil rapidly. (4) Continue to remove foreign matter from the iris surface according to the foreign body removal method in the anterior chamber. (5) After the pupil is reduced, the iris will cover the anterior capsule wound. 2. Intracapsular cataract extraction is performed by intravesical cataract extraction according to the freezing method, and the foreign matter in the crystal is simultaneously taken out. 3. Extracapsular cataract extraction The hand-held electromagnet head is inserted into the pupil area from the limbus incision, and the current is started to suck out the foreign matter. If no foreign body is seen, cataract extraction and aspiration can be performed. It is usually found in the crystal turbidity of the washout. After surgery, the limbal incision was sutured, and BSS fluid or air was injected into the anterior chamber. 4. Non-magnetic foreign body removal (1) Extracapsular cataract extraction for corneal margin 180° incision. (2) Injecting hyaluronic acid Healon into the anterior chamber to restore the depth of the anterior chamber. (3) Take the miniature toothless scorpion into the anterior chamber and directly clamp the foreign body. (4) Foreign objects with the Xiaoyan exit the anterior chamber. 5. Vitrectomy through the flat portion of the ciliary body, combined with lens foreign body removal with posterior capsule rupture. complication 1. Corneal endothelium injury. 2. The iris is broken. 3. Foreign objects fall into the back room. 4. Anterior chamber bleeding. 5. Intra-ball infection.