表面麻醉下白内障超声乳化术治疗高度近视合并年龄相关性白内障  

Treatment of high myopia combined with age-related cataract with phacoemulsification under topical anesthesia

作　　者：董海莲[1] 高博[1] 周伶丽 

机构地区：[1]北京空港医院眼科,北京市101318

出　　处：《眼科新进展》2011年第7期659-661,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨表面麻醉下白内障超声乳化术治疗高度近视合并年龄相关性白内障的临床疗效。方法 对我院2009年1月至2010年12月高度近视合并年龄相关性白内障患者48例(48眼)进行回顾性分析,所有患者在表面麻醉下行白内障超声乳化人工晶状体植入术,术后3d、1个月、3个月检查记录患者术后视力情况,并采用直接检眼镜检查眼底,观察术后屈光状态、眼压及并发症情况。结果 术中3眼发生后囊膜破裂,给予前房玻璃体清除及虹膜周边切除术,均顺利植入人工晶状体;2眼出现晶状体悬韧带部分断裂,经加大黏弹剂剂量后顺利植入人工晶状体。除2眼外,其余患眼术后视力较术前均有显著提高,差异均有显著统计学意义(均为P<0.01)。术后3个月实际与预计植入屈光度差值为(3.28±1.44)D,平均(-2.52±2.13)D。术后后囊膜混浊13眼,其中9眼行Nd:YAG激光后囊膜切开术;虹膜后粘连3眼;5眼出现一过性高眼压,多在术后2～3d内自行恢复;未见其他明显的术后并发症。结论 表面麻醉下白内障超声乳化术治疗高度近视合并年龄相关性白内障具有手术时间短、切口小、痛苦少、恢复快等优点,是较理想和值得推广的方法。Objective To investigate the clinical curative effect of phacoemulsification in treatment of high myopia combined with age-related cataract under topical anesthesia. Methods Forty-eight patients （48 eyes） with high myopia combined with age-related cataract from January 2009 to December 2010 in our hospital were retrospectively analyzed;All patients received the phacoemulsification under topical anesthesia. The visual acuities were recorded at postoperative 3 days, 1 month and 3 months, the refraction, intraocular pressure and complications were observed. Results The posterior capsule ruptured in 3 eyes dtLdng the operation, the vitreous clearing of anterior chamber and iris cutting method were given, then the intraocular lens implanted in all 3 eyes. The partial fracture of suspensorium appeared in 2 eyes,the intraocular lens implanted successfully after giving large dose of sodium hyaluronate. The postoperative visual acuity was improved in 45 eyes,there were significant differences compared with pre-operation （ all P 〈 0.01 ）. The difference between actual diopter and predict diopter was （3.28 ± 1.44） D, averaged in （ - 2.52 ± 2.13 ） D at postoperative 3 months. There were 13 eyes with posterior capsular opacity,in which the dissection of posterior capsule with Nd：YAG laser was performed in 9 eyes. There were 5 eyes with posterior synechias and 5 eyes with transient ocular hypertension, which recovered at postoperative 2 days to 3 days. No other obvious complication was found. Conclusion Phacoemulsification for high myopia combined with age-related cataract under topical anesthesia has many advantages, such as short surgical time, small incision,little pains and rapid recove .ry, which should be generally aoolied.

关 键 词：表面麻醉 白内障超声乳化术 高度近视 年龄相关性白内障 

分 类 号：R776.1[医药卫生—眼科]