corneal foreign body removal

When the eyeball is penetrating, there is often a foreign body in the eyeball. Foreign matter entering the eyeball can be metallic or non-metallic. Metal foreign bodies can be divided into magnetic or non-magnetic. Therefore, when a penetrating injury occurs in the eyeball, it is first necessary to find out whether there is foreign matter in the eye, the nature and position of the foreign matter. The surgical plan can only be developed after the situation has been identified. Treatment of diseases: corneal ulcers, corneal ulcers Indication 1. Foreign body on the cornea surface. 2. Shallow foreign body of the cornea. 3. Deep corneal foreign body. Contraindications Gunpowder powder, coal dust, and sediment located at different depths in the cornea should not be forcibly removed. Because the number is too large, it is covered with face, eyelids, conjunctiva, and cornea. The depth is different, and the foreign matter is soft and loose and cannot be clamped. Such foreign bodies are small, their boundaries are neat, and there is no infiltration; there is no connection between the points, and light can enter the fundus through these gaps, and the patient can maintain certain vision; and these foreign objects can be automatically exposed to the cornea after a certain period of time. In the epithelial layer, the patient has a foreign body sensation in the injured eye. At this time, the foreign body needle is used for picking up or washed with physiological saline. This method of automatic discharge does not damage the corneal parenchyma and does not enlarge the corneal cloud or plaque. Preoperative preparation 1. Perform a slit lamp microscope examination. Identify the size and depth of the corneal laceration; identify the nature of the foreign body; find out the depth of the foreign body into the cornea; whether the elastic layer behind the cornea is broken. If the foreign body is incarcerated in the deep cornea and the posterior corneal elastic layer has broken, you should pay attention to whether the foreign body has reached the anterior chamber. 2. Rinse the conjunctival sac and the corneal surface with saline, pay special attention to the upper iliac crest, and no foreign matter remains. 3. Drop antibiotic solution. The day before surgery, every 2 hours. 4. Prepare the surgical microscope. Surgical procedure 1. Removal of foreign body on the cornea surface: The patient sits in front of the slit lamp, and the surgeon separates the eyelid with a finger, and takes a cotton swab containing physiological saline to take foreign matter. 2. The corneal superficial foreign body is taken out, and the patient is seated in the same position. If you can't use the saline swab, you can use a 7-gauge needle to pick up the foreign body. Note that the needle "horseshoe mouth" is upward and the needle tip is toward the corneal edge. Then wipe the foreign matter with a saline swab. 3. Deep corneal removal: (1) Magnetic foreign matter located in the deep deep layer: The patient sits in front of the slit lamp, and the operator fixes the eyeball with one hand, holds the scalpel with one hand, cuts the corneal tissue on the entrance of the foreign matter, separates the cornea to expose the foreign body, and then sucks it out with a hand-held electromagnet. (2) Non-magnetic foreign matter located in the deep deep layer: a v-shaped incision to the cornea level is made centering on the position of the foreign matter. Taking the v-shaped tip as the starting point, the corneal lamellar layer was separated, and after the foreign matter was revealed, it was picked up with a foreign body needle or clipped with a foreign body, and then washed with physiological saline. (3) Substantial foreign objects such as thorns and sawdust entering the anterior chamber at one end. 1) The foreign body is located in the center of the cornea: fully collapsed, and a small incision is made in the periphery of the cornea. The iris restorer extends from the incision into the anterior chamber, and the foreign body is lifted outward, and the foreign body is used to vertically protrude from the corneal surface. Foreign objects are pinched out. Surgery should be done under a surgical microscope. 2) The foreign body is located near the anterior chamber angle: fully sacral, according to the extracapsular cataract extraction operation, 5-8 mm long incision in the posterior border of the limbus, or 1 to 2 corneal scleral preset sutures can be placed. Open the corneal flap, expose the foreign body, use the foreign body or the toothless crystal to clip the foreign body, close the incision, postoperative 1% atropine eye drops, subconjunctival injection of antibiotics, single eye bandaging. complication eye pain.