Magnetic foreign body extraction at the back of the eye

Inquire about the history of trauma, including the cause of injury, the type, direction, speed and distance of the wound, and the time of injury. It is identified as mechanical or non-mechanical trauma. If it is a mechanical injury, it will further distinguish eye contusion, eye penetrating injury or adnexal injury, and whether there is any foreign body in the eyeball or inside or inside the eyelid. If it is a non-mechanical injury, It should be divided into physical, chemical and so on. The removal of foreign matter in the eye is generally divided into: (1) foreign bodies in the vitreous. (2) Foreign bodies in the wall of the eye. Treatment of diseases: intraocular foreign body in metastatic tumors Indication (1) Foreign bodies in the vitreous. (2) Foreign bodies in the wall of the eye. Preoperative preparation Place mannitol or 50% glycerol orally before surgery. Surgical procedure According to the preoperative positioning, the position of the foreign body in the ball and the chord distance from the limbus are determined. If the foreign object is close to the ball wall, the surgical site is designed at the sclera where the foreign body is located. If the foreign body is in the vitreous, the surgically incision of the sclera should be selected on the flat part of the ciliary body or the edge of the serrated. The suture is opened or opened with a non-magnetic opener. The corneal edge of the warp where the foreign body is located is marked with 1% gentian violet, and a suture is positioned on the contralateral limbus. If the foreign matter is before the serration, no stitching is allowed. In the direction of the warp of the predetermined foreign body, about 8 mm from the limbus, the bulbar conjunctiva parallel to the limbus is incision, the incision is about 10 to 20 mm long, the fascia is cut, and the sclera is exposed. A traction fixed suture is placed at the end of the muscle to cut the extraocular muscle and fully expose the sclera. Pull the positioning suture so that it extends all the way through the center of the pupil and the marker point. According to the local object positioning, the chord distance of the foreign body from the limbus was measured, and 1% gentian violet was used as a marker point on the surface of the sclera. A magnetic test was performed at the site of the scleral marking with an electromagnet. After the magnetic test was found to be positive, the scleral incision was made perpendicular to the limbus at the site, and the incision was slightly longer than the foreign body by 1 to 2 mm, and the depth was 1/2 to 1/3 of the thickness of the sclera. The scleral incision was made as a pre-sewn line, and a row of electrocoagulation was made on each side of the incision. The full-slice incision sclera exposes the choroid for choroidal coagulation and incision, and the foreign body is absorbed by an electromagnet. Tie the preset line and cut it. The cut extraocular muscles were resected and sutured, and the eyeball fascia and conjunctiva were sutured in opposite directions. After the subconjunctival injection of antibiotics and hormones, drop 1% atropine liquid, apply antibiotic eye ointment, double eye bandage (Figure 14). complication (1) postoperative bleeding. Appropriate application of hemostatic agents before and after surgery. (2) Retinal detachment. Preoperative and post-examination, those with holes can be closed with argon hormone; those with fibrous cords can retract the retina, vitreous resection can be performed; those with larger holes can be scleral cerclage; vitreous gas injection for macular holes . (3) Endophthalmitis. Apply antibiotics systemically and topically. (4) Sympathetic ophthalmia. 1 try to protect the eyeball, apply a lot of antibiotics and hormones to the whole body and local application; 2 If the eye injury is serious, there is no possibility of recovery of vision. If there is a possibility of sympathetic ophthalmia, the eyeball should be removed immediately.