剥脱综合征白内障与老年性白内障手术并发症比较分析  

The comparision study on surgical complications of Phaco in exfoliation syndrome versus senile cataract

作　　者：李弘[1] 苏静[1] 牟晓燕[1] 郭隽[1] 孟祥俊[1] 杨扬[1] 李丹[1] 

机构地区：[1]大连大学附属中山医院眼科,大连116001

出　　处：《中国实用眼科杂志》2012年第5期510-512,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的比较施行白内障超声乳化摘除人工晶状体植入术的剥脱综合征（exfoliation syndromeXFS）与单纯老年性白内障两组病人术中、术后并发症的发生情况，探讨XFS的手术风险。方法临床病例对照研究。对2003年1月至2011年5月在大连大学中山医院眼科统计分析38例40只眼XFS白内障及同期施行手术的单纯老年性白内障38例50只眼术中、术后并发症的发生情况。统计学方法采用x^2检验。结果XFS组5只眼术中瞳孔不能散大而单纯老年性白内障组无一只眼发生；XFS组3只眼发生术中晶状体悬韧带断裂而单纯老年性白内障组仅1只眼发生；3只XFS眼、5只单纯老年性自内障眼术中晶状体后囊膜破裂；XFS组中4只眼术后发生高眼压甚至青光眼而单纯老年性白内障组无1只眼发生；术后后发障发生情况分别为XFS组中5只眼、单纯老年性白内障组7只眼；至于国外报道的手术后人工晶状体一囊袋复合物移位甚至脱位在两组病例中均未发现。结论XFS眼白内障手术中瞳孔散大困难、悬韧带脆弱、断裂风险高于单纯白内障，且术后仍有可能发生剥脱性青光眼。术前认真准备、充分认识手术风险、术中仔细操作并选择恰当的处置方法、术后长期随访至关重要。Objective To evaluate intraoperative and postoperative complications of Phaco on ex- foliation syndrome （XFS） versus senile cataract. Methods The records of 38 patients （40 eyes） with XFS and 48 patients （50 eyes） with senile cataract having Phaco were reviewed. Their intraoper- ative and postoperative comlications of Phaco were analyzed and summarized. Results Five XFS eyes having reduced papillary dilation but none in senile cataract group; dialysis of zonule occurred in 3 XFS eyes and 1 eye in senile cataract group; rupture of posterior capsule occurred in 3 XFS eyes and 5 eyes in senile cataract group; exfoliated glaucoma occurs in 4 XFS eyes but none in se- nile cataract group even after Phaco. After cataract happened in 5 XFS eyes and 7 eyes in senile cataract group respectively. None of 2 groups had late in-the-bag intraocular lens dislocation. Con- clusions The Risk of reduced papillary dilation, weakness and dialysis of zonule are increased in XFS eyes having Phaco, and exfoliated glaucoma may occur even after Phaco surgery. Preoperative evaluation of surgical complications, the options for intraoperative management and careful operation, long- period follow- up are very important.

关 键 词：超声乳化术 手术并发症 剥脱综合征 

分 类 号：R776.1[医药卫生—眼科]