前房注气术治疗白内障术中角膜后弹力层脱离的观察  

Clinical study of anterior air for Descemet＇s membrane detachment during cataract surgery

作　　者：史庆成[1] 周衍文[1] 初玲[1] 

机构地区：[1]沈阳爱尔眼视光医院,沈阳110003

出　　处：《中国实用眼科杂志》2013年第1期80-82,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察前房注气术治疗白内障超声乳化手术导致角膜后弹力层脱离（Descemet’smembranedetachment，DMD）的临床效果。方法回顾分析2006年5月至2012年3月问，通过前房注气术治疗白内障超声乳化手术导致角膜后弹力层脱离的患者23例。其中大于1／2角膜面积的广泛后弹力层脱离3例（含伴有部分后弹力层缺失1例），大于1，3并小于1／2角膜面积的后弹力层脱离6例（含伴有部分后弹力层缺失1例），小于1／3角膜面积的后弹力层脱离14例。所有患者均于术毕前前房注入无菌空气，利用气泡顶压脱离的后弹力层复位；后弹力层复位不良或空气吸收后仍未复位者，以同样方法再次注气。结果前房内空气于术后3～5d吸收，20例患者经1次注气角膜恢复透明；2例经2次注气，1例经3次注气，均为脱离范围大于1／3角膜面积的患者；伴有部分后弹力层缺失的2例患者恢复较慢，最长达2个月角膜恢复透明。结论前房注气术治疗白内障术中角膜后弹力层脱离，方法简单易行，可以重复操作，临床疗效确切。Objective To observe clinical effect of anterior air to treat Descemet＇s membrane de- tachment caused by Phacoemulsification cataract surgery. Methods Retrospective analysis of 23 pa- tients who were performed anterior air for Descemet＇s membrane detachment during Phacoemulsifica- tion cataract surgery from May 2006 to March 2012. Three cases had greater than 1/2 of the corne- al area of extensive Descemet＇s membrane detachment （contains missing part of the Descemet＇s mem- brane one case）, 6 cases had greater than 1/3 less than 1/2 of it （contains missing part of the Des- cemet＇s membrane one case）, 14 cases had less than 1/3 of it. All patients＇ anterior chamber was in- jected sterile air to reset detached Descemet＇s membrane in the end of surgery. If detached Des- cemet＇s membrane had not been reset, using the same methods. Results The air in the anterior chamber was absorbed in 3-5 days after surgery. Twenty patients＇ cornea became transparent after a single gas injection; corneal area of Descemet＇s membrane detachment was greater than 1/3 in other patients, two of them were after three gas injection, one of them was after one gas injection. Two patients＇ corneal Descemet＇s membrane recover slowly, at last became transparent until 2 months. Conclusions Anterior air can treat corneal Descemet＇s membrane detachment during cataract surgery. The method is simt^le. It can overate reoeatedlv. The treatment effect is exact.

关 键 词：白内障手术 后弹力层脱离 前房注气 

分 类 号：R779.66[医药卫生—眼科]