微创玻璃体切割系统在硅油取出术中的应用  

The application of micro-incision vitrectomy system in the method to remove silicone oil combined with secondary posterior chamber intraocular lens implantation.

作　　者：柯治生[1] 宋宗明[1] 王瑞华[1] 

机构地区：[1]温州医学院附属眼视光医院,温州325000

出　　处：《中国实用眼科杂志》2010年第1期72-74,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨硅油填充眼微创玻璃体切割系统经角膜切口硅油取出联合二期后房型人工晶状体植入术的临床疗效。方法对21例21只已实施白内障超声乳化玻璃体切除并硅油填充术眼，均采用25G经结膜免缝合玻璃体切割灌注系统，通过角膜切口方法取出硅油并人工晶状体植入联合手术。术后密切随访3月以上。记录手术建立2个通道和关闭切口所需要的时间，观察手术前后的眼压、最佳矫正视力及术后并发症。结果21只眼内硅油均1次成功取出，人工晶状体植入囊袋内10例；植入睫状沟11例，手术单独做2个灌注的平均时间为（46．00±4．12）S，关闭灌注通道需要的平均时间为（41．00±5．36）s。手术前1d、后第1d、1周、1个月、3个月时的平均眼压分别为（15．63±6．98）mmHg、（10．37±5．24）mmHg、（14．13±4．87）mmHg、（18．60±7．73）mmHg、（16．80±6．35）mmHg；术后矫正视力较术前均有不同程度的提高，85．7％（18／21）提高2行以上。异物感：0％（0／21），结膜水肿及充血：4．76％（1／21）；所有患者均无复发视网膜脱离、人工晶状体移位等并发症发生。结论微创玻璃体切割系统经角膜切口这种硅油取出联合人工晶状体植入术是一种安全、简单有效地方法。Objective To investigate clinical effect of micro-incision vitrectomy system in the method to remove silicone oil combined with secondary posterior chamber intraocular lens implantation by corneal tun- nel incision.Methods Of 21 patients who once had phacoemulification and pars plana vitrectomy combined with silicone oil tamponade underwent silicone oil removal and intraocular lens implantation by corneal tunnel incision with 25-gauge trans-conjunctival sutureless vitrectomy irrigation system,Follow-up was more than 3 months.The time of procedures of setting-up the two-port carmulae and closing the cuts were recorded.The pre-and post-operative ocular tension, visual acuity and complications were observed.Results All 21 eyes obtained primary success in extracting of silicone oil.The IOL was inserted in the lens bag in 10 cases and in the ciliary sulcus in 11 cases.The average time of setting-up the two-port cannulae and closing the cuts was 46.00± 4.12 seconds and 41.00±5.36 seconds respectively.The average preoperative ocular tension was 15.63±6.98mmHg, the average postoperative ocular tension at the first day, first week, first month and third month was10.37±5.24mmHg, 14.13 ± 4.87mmHg, 18.60± 7.73 mmHg, 16.80±6.35mmHg, respectively.The post-BCVA was better than the pre-BCVA in varied degree and increased two or more lines of vision in 85.7% （ 18/21 ） of cases.Foreign body sensation： 0% （0/21）, conjunctival chemotic and hyperemia： 4.76% （ 1/21 ）, lens dislocation, retinal detachment and other special postoperative complications were not observed in any patients.Conclusions The method to remove silicone oil and implant intraocular lens by corneal tunnel incision with micro-incision vitrectomy system is a safe, simple and effective

关 键 词：硅油取出 25G玻璃体切割系统 无晶状体眼 角膜隧道切口 人工晶状体植入 

分 类 号：R774.12[医药卫生—眼科]