摘要目的:分析伴眼内异物(IOFB)的开放性眼外伤并发视网膜脱离(RD)的临床特点及危险因素。方法:回顾性病例对照研究。收集汕头大学·香港中文大学联合汕头国际眼科中心2008年1月至2020年5月诊断为伴眼内异物的开放性眼外伤共269例(269只眼)的临床资料。根据影像学检查结果及手术记录明确RD的诊断，将病例分为无RD组234例(234只眼)及RD组35例(35只眼)。比较两组间受伤情况、损伤特点、并发症及手术方式，按RD发生于术前或术后分别纳入因素回归分析并发RD的危险因素。结果:所有病例均行眼内异物摘出术。影像学及手术确诊眼内异物并发RD 35例(13.01%，35/269)，以金属异物(34例)为主。其中27例术前合并RD，二分类logistic回归分析结果为：术前视网膜前膜( OR＝9.02， P＝0.019)、晶状体损伤( OR＝8.45， P＝0.046)、玻璃体积血( OR＝5.28， P＝0.001)及异物深度分级( OR＝3.04， P＝0.002)。15例术后并发RD，二分类logistic回归分析结果为：术后视网膜前膜( OR＝17.67， P<0.001)和异物位置分级( OR＝1.90， P＝0.044)。 结论:IOFB并发RD以金属异物为主，术前RD的合并危险因素是术前视网膜前膜、晶状体损伤、玻璃体积血及异物深度分级。术后RD的合并危险因素是术后视网膜前膜和异物位置分级。

abstractsObjective:To analyse the risk factors of retinal detachment (RD) caused by open ocular trauma with intraocular foreign body (IOFB).Methods:This was a retrospective case-control study. The clinical data of 269 eyes of 269 patients diagnosed of open ocular trauma with IOFB from Jan.2008 to May 2020 in the Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong were collected. According to the imaging results and surgical records, the diagnosis of RD was confirmed, and the patients were divided into the non-RD group (234 eyes of 234 patients) and the RD group (35 eyes of 35 patients). The differences of injury condition, injury characteristics, complications and surgical methods between the two groups were compared. Factors were included respectively according to the occurrence of RD before or after operation and then the risk factors of RD were analyzed by regression analysis.Results:All patients had received IOFBs extraction surgery. Imaging and surgery confirmed IOFBs complicated with RD in 35 cases (13.01%, 35/269), mainly metallic IOFBs (34 cases). Among them, 27 cases were complicated with RD before operation. The results of binary logistic regression analysis were as follows: preoperative epiretinal membrane ( OR=9.02, P=0.019), lens injury ( OR=8.45, P=0.046), vitreous hemorrhage ( OR=5.28, P=0.001) and IOFB depth grading ( OR=3.04, P=0.002). There were 15 cases complicated with RD after operation. The results of binary logistic regression analysis were: postoperative epiretinal membrane ( OR=17.67, P<0.001), and IOFB site grading ( OR=1.90, P=0.044). Conclusion:RD caused by IOFB are mostly from metallic objects. The combined risk factors for preoperative RD are preoperative epiretinal membrane, lens injury, vitreous hemorrhage and IOFB depth grading. The combined risk factors for postoperative RD are postoperative epiretinal membrane and IOFB site grading.