Objective To evaluate the therapeutic effect of vitreo-retinal surgery on oclular siderosis. Methods The clinical data of 22 patinets (22 eyes) with ocular siderosis due to the magnetic foreign body at intraocular postsegment were retrospectively analyzed. The patients aged from 6 to 54 years (average 40 years), including 21 males and 1 femal. The duration of the magnetic foreign body remained in the eye lasted for 1 month to 20 years. The preoperative best corrected visual acuity (BCVA) was ＜0.01 in 15 eyes, 0.01-0.15 in 5 eyes and 0.1-0.2 in 2 eyes. There was Intra-vitreous foreign body in 18 eyes and ocular wall embedded foreign body in 4 eyes; intraocular foreign body (IOFB) combined with cataract in 18 eyes; combined with retinal detachment in 3 eyes; scleral buckling combined with silicon oil filled in 12 eyes and C3F8 filled in 7 eyes. Cataract extraction was performed in 12 eyes, and 2 eyes underwent filtrating surgery. Results The IOFB was successfully removed by one-off surgery in 22 eyes. BCVA increased in 20 eyes (90.9％) and kept unchanged in 2 eyes (9.1%), including＜0.1 in 7 eyes, 0.1-0.4 in 8 eyes, and 0.5-1.0 in 7 eyes. Operative complications involved retinal holes with retinal detachment in 2 eyes and vitreous haemorrhage secondary to enlarge sclera incision in 2 eyes. Postoperative complications included secondary cataract in 4 eyes, retinal detachment due to silicon oil removal 3 months after submacular removal of foreign body in 1 eye, and retinal detachment 7 days after C3F8 filling in 1 eye; the latter two eyes had reattached retina after another silicon oil filling. At the end of the follow-up period, retina reattached in 22 eyes. Conclusion Advanced modern vireoretinal operation is effective on oclular siderosis, which can avoid the release of Fe+ and improve the patientsprime; visual function.
Objective To observe the clinical characteristics of severe ocular detonator explosive injuries and to evaluate the therapeutic effects of vitrectomy on it. Methods Clinical data of 37 consecutive patients (65 eyes) with severe ocular detonator explosive injuries were retrospectively analyzed. The patients included 36 males and 1 female with the average age of 28.6 years. The biocular injuriy was in 31 cases (83.8 %), and one-eyed injury was in 6 cases (16.2%). A total of 48 eyes had severe explosive injury. The visual acuity was no light perception in 9 eyes in which 3 eyeballs were obviously atrophic, light perception in 28 eyes, hand moving in 4 eyes, and counting finger/33 cm in 7 eyes. Vitrectomy was performed on 46 eyes, in which 41 had severe ocular explosive injury. There were no vitreous surgery indications in 13 eyes of 19 eyes didnprime;t undergo surgery; the other 6 eyes didnprime;t undergo surgery due to the atrophic eyeballs or economic reasons. The treating time after trauma was within 1 week in 7 patients (18.9%), 1 week to 1 month in 13 (35.2%), and more than 1 month in 17 (45.9%). The follow-up duration lasted 6 months to 2 years after operation with the average of 8.6 months. Results In 65 eyes, the occupation ratio of conjunctival foreign bodies was 66.2%; corneal foreign bodies was 46.2%; vitreous hemorrhage was 70.8%; intraocular foreign bodies (IOFB) was 69.2%; retinal shocking injury or optic nerve blasting injury was 56.9%. The visual acuity improved in 33 eyes, remained unchanged in 25 eyes, and decreased in 7 eyes. In 46 eyes which had undergone vitrectomy, IOFB injuries was in 35 eyes (76.1%); the visual acuity increased in 26 eyes (59.5%), remained unchanged in 13 eyes (28.3%), and didnprime;t cure in 7 eyes (15.2%) in which 2 eyes underwent ocular enucleation and 5 eyes were atrophic. The increasing rate of visual acuity in the patients who accepted the treatment more than 1 month after injury was low. The occupation ratio of monocular blindness was 51.4% and biocular blind was 8.1%. Conclusions Most of severe ocular explosive injuries by detonator are with IOFB. causes of the high blinding rate are late treatment and serious injury. Strengthening the diagnosis and treatment of retinal shock and optic nerve blast, and performing vitrectomy as soon as possible can improve prognositc visual function of injured eyes.
Objective To analyze and summarize the clinical characteristics of foreign body incarceration in upper digestive tract, and to explore the risk factors of its complications. Methods The clinical data of patients with foreign bodies in the upper digestive tract treated in the Affiliated Hospital of Zunyi Medical University between January 1, 2012 and December 31, 2021 were retrospectively analyzed, including demographic data, foreign body type, incarceration site, incarceration time, causes, symptoms, treatment methods and complications of foreign body incarceration. Logistic regression analysis was used to explore the risk factors of complications. Results A total of 721 patients were finally included, ranging in age from 3 months to 90 years old, with an average age of 26.76 years. The proportion of foreign bodies in the upper digestive tract in patients ≤14 years old was the highest (51.18%), and the duration of foreign body incarceration<12 hours was the highest (55.34%). The most common sharp foreign bodies in the upper digestive tract were animal bones (228 cases), and the most common round shaped foreign bodies were coins (223 cases). The most common impaction site was the upper esophageal segment (85.02%). 105 patients (14.56%) had complications, and perforation was the most common (5.55%). Logistic regression analysis showed that age [odds ratio (OR)=0.523, 95% confidence interval (CI) (0.312, 0.875), P=0.014], foreign body type [OR=0.520, 95%CI (0.330, 0.820), P=0.005], incarceration site [OR=2.347, 95%CI (1.396, 3.947), P=0.001], incarceration time [OR=0.464, 95%CI (0.293, 0.736), P=0.001] were the influencing factors of complications. Conclusions The majority of foreign bodies in the upper digestive tract are animal bones. The incidence of complications increase in patients with age ≥ 60 years, sharp foreign body edges, incarceration in the upper segment of the esophagus, and long incarceration time. It is recommended to remove the sharp foreign bodies incarcerated in the upper segment of the esophagus from the elderly as soon as possible.