白内障超声乳化吸出术中晶体核脱入玻璃体的临床分析  

Clinical observation of dropped nucleus during phacoemulsification

作　　者：刘宗明 王文田 许成玉 杨育勇 刘秀文 游浩凌 

机构地区：[1]河北省张家口市第四医院眼科,075000

出　　处：《眼科》2000年第4期204-206,共3页Ophthalmology in China

摘　　要：目的 :报告Kelman晶体乳化白内障吸出术 (Kelman’sphacoemulsificationcataractextraction ,KPE)中晶体核脱入玻璃体腔的发病率、临床表现和处理方法。方法 :回顾我院 1 996年 5月～ 1 998年 6月间 4 40 0例中KPE手术中晶体核脱入玻璃体 1 0例病人的临床表现及处理方法。结果 :晶体核掉入玻璃体发生率为 0 2 3 %。掉核后发生高眼压者 1 0 0 % ;掉核≤ 1 /4、KPE手术Ⅰ期植入前房型人工晶体(AC IOL) 3例 ,术后视力均≥ 0 5;掉核后 2周内实施玻璃体切割手术 4例 ;玻璃体切割术后植入AC IO L2例 ,术后矫正视力均≥ 0 4 ;掉核≥ 1 /2、未经玻璃体切割术取核者 3例 ,术后视力均低于 0 0 1。结论 :掉核≤ 1 /4可Ⅰ期植入前房型人工晶体 ,不需手术治疗亦能获得较好的视力 ;掉核≥ 1 /2 ,必须经玻璃体切割术取核 ,否则 ,视力预后极差 ;通过玻璃体切割手术取核 ,可以使大多数病人最终获得良好的视力 ,而且是处理此种并发症唯一正确的方法。HT5”SS][WT5”BZ][ST5”BZ]Objectives:To report the incidence,clinic features and management of dropped nucleus during phacoemulsification.Methods:A retrospective review of the postoperative conditions of 10 patients who had lens nucleus dropped into vitreous during phacoemulsification.Results:Of the 4400 patients with cataract who underwent phacoemulsification,lens nucleus dropping into vitreous occurred in 10 patients(0.23%).After dropping of lens nucleus IOP elevated in all 10 patients(100%).Postoperatively,the best corrected visual acuity(VA)of 3 patients with dislocation of smaller than 25% of lens material and primary AC IOL placement during KPE was 0.5 or better,while that of 4 patients who underwent vitrectomy within 2 weeks after KPE was 0.4 or better,and that of 3 patients with dislocation of greater than 50% of lens material and without vitrectomy was 0.01 or worse.Conclusions:Small pieces of retained lens fragments in vitreous(<25%)may allow AC IOL implantation and surgical removal may not be required.If greater than 50% of lens material was dislocated into vitreous,surgical removal of dislocated crystalline lenses must be performed,otherwise,it may result in very poor visual outcome.In most patients with retained lens fragments in the vitreous during phacoemulsification,vitrectomy allowed good visual acuity outcomes,and it was the only correct method of managment. [HT5”H][WT5”HZ][ST5”HZ]

关 键 词：白内障 玻璃体切除术 人工晶体植入术 治疗 

分 类 号：R779.66[医药卫生—眼科]