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患者卢××,男性,48岁,水电装修工.因右眼突起红痛、畏光、流泪2周于1993年7月30日就诊.视力:右眼眼前指数,左眼0.8.右眼刺激征(++),球结膜睫状充血(++),角膜颞下部有一约1×2mm之全层灰白浑浊,角膜后有尘样色素性沉着物(++),Tyndall征(++).虹膜纹理不清,瞳孔约3×3.5mm,边缘不整齐,下方瞳孔缘广泛后粘连,光反射迟钝.瞳孔区见一黑色物横置于晶体表面.晶体呈灰白色不均匀浑浊,部分皮质已吸收.眼底窥不进.指测眼压T-3.左眼未见异常.按急性虹膜睫状体炎处理原则治疗2天后患者自觉症状和体征迅速消退.追问病史,患者于38年前即10岁时在田间跑步不慎跌倒,被剑麻棘刺伤右眼.经治疗红痛消失,以后该眼视力一直不好,但38年来未再红痛过.会诊认为晶体上之黑色物可能是剑麻棘刺.X光薄骨照片阴性,A超检查报告:右眼玻璃体浑浊波形,有可疑视网膜脱离波形.收入院于8月13日在局麻下作右眼眼内异物搞出术及白内障囊外摘出术.手术台上见异物几乎成平行斜插入晶体前皮质内,粘连较紧,需用力拔除.取出之异物为4×0.9mm的黑色刺状物,另一端如针尖,质坚硬,与患者所说之剑麻棘刺相符.晶体囊很厚,呈钙化状,与虹膜粘连,用破囊针无法刺破,用小剪刀剪除,晶体核裂成3块娩出.玻璃体有机化物与晶体粘连,手术在显微镜下看不见眼底红光
Patient Lu × ×, male, age 48, plumbers due to right eye protrusion pain, photophobia and tearing for 2 weeks on July 30, 1993. Visual acuity: right anterior index, left eye 0.8, right eye stimulation Sympathetic (++), ciliary conjunctival ciliary hyperemia (++), corneal temporal lobe has a full layer of about 1 × 2mm gray turbidity, dust-like pigment after the cornea (++), Tyndall sign (++) Iris texture is unclear, the pupil is about 3 × 3.5mm, the edge is not regular, the bottom of the pupillary margin after a wide range of adhesions, light reflex slow pupil area to see a black substance placed transversely on the crystal surface of the crystal was gray and turbid, part of the cortex Absorption .Peeposcopy can not enter .Refers to the intraocular pressure T-3 .And no abnormality in the left eye.Acute iridocyclitis treatment according to the principles of treatment 2 days after the patient’s symptoms and signs of rapid subsidence.Question history, the patient 38 years ago 10 years old running in the field accidentally fell, was sisal thorns hurt the right eye after treatment of pain disappeared, the eyesight has been poor, but no longer red pain over 38 years. Consultation that the crystals on the black may Is a sisal thorns.X-ray thin bone photo negative, A ultrasound report: right eye vitreous turbidity waveform, there is suspicious retinal detachment waveform .Revenue hospital on August 13 at Under anesthesia for the right intraocular foreign body out of surgery and extracapsular cataract extraction surgery table see foreign body almost parallel oblique into the anterior cortex of the crystal adhesions tight need to force removal foreign body was removed 4 × 0.9mm Black spines, the other end, such as the tip, hard quality, consistent with the swords and thorns described by the patient Crystal capsule is thick, calcified, with the iris adhesion, broken with broken needles can not be punctured, scissors cut with a small, Nuclear cleft into three delivered. Vitreous organic and crystal adhesions, surgery under the microscope can not see the red eyes