单通道玻璃体切除在外伤性白内障术中应用  

The application of one-port vitrectomy in surgical treatment for traumatic cataract.

作　　者：史要武[1] 姜倩钰[1] 刘晓[1] 

机构地区：[1]大连市中心医院眼科,辽宁大连116032

出　　处：《眼外伤职业眼病杂志》2007年第11期830-832,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的探讨晶状体前、后囊均破裂的外伤性白内障,经睫状体平坦部的单通道的前部玻璃体和晶状体切除术的效果。方法角巩膜穿透伤伴外伤性白内障26例(26眼)。术前视力:光感14眼,手动5眼,数指7眼。均在一期外伤清创缝合后进行二期玻璃体切除联合手术。玻切通道位于颞上方角膜缘后3.5～4mm处睫状体平坦部,另一切口为12点位角膜缘后2mm处的巩膜角膜隧道切口,切口宽2.8mm于透明角膜内2mm处进入前房。经巩膜切口插入玻切头,经隧道切口插入注水针头,进行前段玻璃体及晶体切除术,经角巩隧道植入折叠式人工晶状体。结果术后3个月视力0.2者5眼,0.3者4眼,0.5者8眼,0.8者6眼,1.0者3眼。术后5眼出现一过性高眼压,经对症处理后缓解,3例病人因虹膜损伤出现虹膜夹持。结论此手术方法简捷、手术效果佳、术中损伤小、视力恢复快,而且并发症少。Objective For traumatic cataract with ruptured anterior and posterior capsule, the anterior segment vitrectomy through limbus approach cannot remove the residual cortical material and the vitreous body in the anterior chamber completely, and cannot reserve the remaining capsule effectively, which made it dif- ficult to implant the intraocular lens. While the vitrectomy and lensectomy through one-port transscleral incision at the pars plana could do all these effectively. Methods 26 eyes of 26 traumatic cataract with corneoscleral penetrating injuries patients, of which 24 were male and 2 were female,whose age ranged from 3 to 61, were included. The preoperative visual acuities were light percep- tion in 14 eyes, hand movement in 5 eyes and counting fingers in 7 eyes. The intervals from injury to surgery （all patients received in- stant suturing of the wound） , except 2 cases of secondary glaucoma treated with our technique 2 - 3 days after the trauma, were man- aged 5 -7 days after the trauma. The vitrectomy port were made atthe pars plana 3.5 - 4 mm from the limbus, the other 2. 8 mm scleral tunnel incision was made at 12 o＇ clock 2 mm from the lim- bus, the vitrector was inserted into the eye through the scleral inci- sion and the infusion canula through the other incision, anterior vit- rectomy were performed to remove the cortical material and the vit- reous body. The anterior capsule of the lens should be reserved as far as possible. The scleral incision was sutured after vitrectomy and foldable intraocular lens was implanted after Healon was injec- ted into the anterior chamber, the operation was completed after a careful infusion - aspiration. Results The postoperative visual a- cuities at 1 week were 0.1 in 4 cases,0.2 in 6 cases,0.3 in 6 ca- ses,O.5 in 8 cases and above 0.8 in 2 cases, at 3 months were O. 2 in 5 cases,O. 3 in 4 cases,O. 5 in 8 cases,O. 8 in 6 cases and 1.0 in 3 cases. Postoperative complications： Secondary glaucoma appeared in 3 cases,and disappeared after medication. In 2 cases

关 键 词：白内障 外伤性 玻璃体切除术 

分 类 号：R779.66[医药卫生—眼科]