玻璃体灌注下白内障超声乳化人工晶状体植入术  

Cataract phacoemulsification combined IOL implantation under vitreous irrigation in previously vitrectomized eyes

作　　者：鲍永珍[1] 曹晓光[1] 梁勇[1] 黎晓新[1] 

机构地区：[1]北京大学人民医院眼科,北京100044

出　　处：《中国实用眼科杂志》2005年第7期742-744,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨玻璃体切割术后的白内障患者行玻璃体灌注下的白内障超声乳化术特点、手术并发症和视力预后。方法对52例52只眼玻璃体切除术后白内障行玻璃体灌注下的白内障超声乳化术,观察记录术中情况、术中术后并发症和视力预后。结果2只眼在白内障超声乳化术中出现“灌注偏离综合症”,39只眼可见角膜后壁细小灰白色乳化硅油集聚并排出眼外。所有病例未出现巩膜塌陷、晶状体掉入玻璃体腔等术中并发症,11只眼术中发现后囊混浊机化,其中9只眼行后囊连续环行撕囊术并植入后房型人工晶状体,2例撕除全部后囊植入前房型人工晶状体。52只眼术后视力较术前提高,术后并发症少。结论对曾行硅油填充、虹膜后粘连、小瞳孔、多次手术后低眼压、怀疑晶状体损伤的复杂性玻璃体切割术后白内障患者在超声乳化术中应行玻璃体腔液体灌注以利手术操作和减少手术并发症,提高手术质量。Objective To evaluate the intraoperative difficulties and characteristics of cataract phacoemulsification in eyes that had undergone pars plana vitrectomy and to determine complication rates and visual outcomes. Methods A prospective study of cataract phacoemulsification with vitreous irrigation according to the clinical features was conducted on 52 patients(52 eyes)after vitrectomy performed by a single surgeon.Data were collected on preoperative characteristics,intraoperative observations and complications,postoperative complications,and visual acuities. Results 2 of 52 cases appear “Infusion deviation syndrome” during the operation.11 eyes were found posterior capsular fibrosis during operation,and 9 eyes obtained PCCC combined PC-IOL,another 2 eyes were taken whole capsular bag and implanted AC-IOL. Conclusions Cataract phacoemulsification is an effective way for treating cataract patients after vitrectomy.Surgeons need to be aware of additional challenges.Combination with vitreous irrigation is necessary in cases with previously silicone oil tamponade,small pupi,iris adherence,suspicious lens damage or zonular instability and hypotony.

关 键 词：超声乳化人工晶状体植入术 白内障超声乳化术 后房型人工晶状体 前房型人工晶状体 玻璃体切除术后 白内障患者 玻璃体切割 手术并发症 术后并发症 视力预后 玻璃体腔 术中并发症 虹膜后粘连 术后低眼压 晶状体损伤 观察记录 

分 类 号：R776.1[医药卫生—眼科] R779.66[医药卫生—临床医学]