A超分段测量法在硅油填充眼并发白内障三联手术中应用  

The using of A-scan echography in the triple surgery treating silicone oil complicated cataract

作　　者：潘颖喆[1] 高丰[1] 王慧[1] 

机构地区：[1]湖北医药学院附属襄阳医院,襄阳市第一人民医院眼科,襄阳441000

出　　处：《中国实用眼科杂志》2012年第3期255-258,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的评价A超分段测量法对硅油填充眼进行生物测量的准确性，以及“自内障超乳摘除、硅油取出联合人工晶状体植入术”治疗硅油填充眼并发白内障的安全性及手术效果。方法临床病例系列研究。对2009年1月至2010年12月在襄阳市第一人民医院眼科选取硅油填充眼并发性白内障患者11例11只眼，术前使用A超分段测量法进行生物测量。术中经巩膜隧道切口行白内障超乳摘除，经睫状体平坦部穿刺口置入20G套管针抽吸出玻璃体腔内硅油，囊袋内植入PMMA或丙烯酸酯折叠人工晶状体。随诊至术后6个月。结果术前硅油填充眼眼轴长度为22．17～29．38mm，平均（25．46±2．20）mm。所有患者手术经过顺利，人工晶状体植入囊袋，随访至术后6月无特殊并发症发生。裸眼视力0．1～0．3者8例8只眼，0．4，0．6者3例3只眼。屈光状态（等效球镜度）介于-1．5～＋0．25D之间，与目标屈光状态的平均绝对屈光误差值为（0．77±0．32）D（0．25～1．25D）。结论“三联手术”治疗硅油填充眼并发白内障安全、可靠，效果良好，“A超分段测量法”可对并发白内障的硅油填充眼进行准确的生物测量，并计算出合适的人工晶状体度数。Objective To evaluate the accuracy of the biometry using A-scan echography for the axial length （AL） of silicone oil-filled eyes, and the security of the phacoemulsification combined sili- cone oil removal and intraocular lens implantation. Methods Eleven silicone oil-filled eyes combined with complicated cataract in 11 patients were included in the study. The ALs of all the silicone oil-filled eyes was measured with A-scan ecbography before operation. The silicone oil bubble＇s length equals 0.644 times the length measured with the sound velocity 1 532 m.s-1. The depth of the water layer beneath the oil bubble was also included in the calculation of the AL with echogra-phy. All of these eyes underwent phacoemulsification combined with silicone oil removal and intraocular lens implantation. The deviation of the refraction between the target and the actual was assessed post-operatively. Results ALs pre-surgical measured by A-scan echography were 25.46±2.20mm （22.17-29.38 mm）. All of the operations were performed successfully; IOLs were placed in- to the capsule bag. No complication took place at 6 months. The uncorrected visual acuity after op- eration of 8 patients＇ was 0.1-0.3, and of 3 patients＇ was 0.4-0.6. The refractive bias （described as spherical equivalent） after intraocular lens implantation was 0.77±0.32D （0.25-1.25D）, 4 of them ≤＋ 0.5D （36%）, 9 of them ≤＋1.0D （82%）, only 2 of them （18%） was 1.25D. Conclusions The AL of eyes tamponaded with silicone oil and combined with complicated cataract can be measured reliably with A-scan echography. Phacoemulsification combined plantation is effective, safe and reliable method for the silicone oil removal and intraocular lens imtreating of silicone oil complicated cataract.

关 键 词：硅油填充眼 生物测量 A型超声 白内障 人工晶状体 

分 类 号：R779.6[医药卫生—眼科]