90岁以上老年人白内障超声乳化吸除术的临床观察  

Clinical Observation on Phacoemulsification Performed in Senile Cataract Patients Elder than 90 Years

作　　者：蔡小军[1] 陈贵芹[1] 李道全[1] 

机构地区：[1]武汉大学中南医院眼科,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2007年第2期251-253,共3页Medical Journal of Wuhan University

摘　　要：目的:分析90岁以上老年人白内障手术特点及相关组织变化。方法:总结90岁以上高龄白内障超声乳化手术52例(66只眼)临床资料及术中体会。结果:这组病例均有不同程度老年环,部分病例周边角膜变性混浊较宽。角膜内皮细胞计数:1 981.6-2 581.4个/mm2,平均(2 147.0±406.7)个/mm2。核硬度:Ⅱ级核1眼,Ⅲ级核31眼,Ⅳ级核28眼,Ⅴ级核6眼。完整连续环形撕囊术(CCC)63眼,术中后囊破裂1眼。术后3 d视力:2眼<0.1,16眼0.1-0.3,33眼0.4-0.6,15眼0.7-1.0。术后3 d,35眼角膜透明,12眼内皮斑片状混浊,8眼内弹力层皱褶,11眼切口附近角膜上皮露状水肿。结论:90岁以上老年人眼部组织老化明显,角膜透明区常减小,但内皮细胞功能多能耐受手术。囊膜较薄而易碎,但完整囊袋可承受手术时核在其内的运动。核多较大,硬度个体差异大。眼底视网膜及脉络膜组织有不同程度退行性改变。Objective. To analyze the relative tissue pathologic change and surgical characteristics of senile cataract in patients elder than 90 years. Methods. A total of 66 eyes of 52 senior patients elder than 90 years underwent phacoemulsification. The clinical material and realization were collected. Results： These cases all had cornea arcus senilis to some extent. The range of opaque marginal cornea of some patients was fairly wide. The endothelial cells were 1981.6-2581.4/mm^2, and the average was （2 147.0±406.7）/mm^2. The nucleus hardness were grade Ⅱ in one eye, grade Ⅲ 31 eyes, grade Ⅳ 28 eyes and grade Ⅴ 6 eyes. The CCC of 63 eyes was complete and one posterior capsule was broken during the surgery. The vision on the third day postoperatively was less than 0. 1 in 2 eyes, 0.1-0.3 in 16 eyes, 0.4-0.6 in 33 eyes and 0.7-1.0 in 15 eyes respectively. On the third day postoperatively, 35 corneas were clear, 12 eyes had fleckily turbidity in cornea endothelium, 8 eyes had slight striae on decement＇ membrane and 11 eyes＇ cornea epithelium became dropsical around incision. Conclusion. The ocular tissue of patients more than 90 years old is obviously degenerative. The clear area of the cornea often decreased, but the endothelial cells are still able to bear the surgery. The capsules are thin and fragile, but complete capsule bag can still support the movement of nucleus during the surgery. Most nucleuses are big and their hardness is different. The retina and choroids are often degenerative to some extent.

关 键 词：高龄 白内障 超声乳化 

分 类 号：R776[医药卫生—眼科]