超声乳化术中25G玻璃体腔灌注的应用效果  

The application of 25G vitreous infusion in phacoemulsification

作　　者：李雯[1] 荣翱[2] 

机构地区：[1]上海市第六人民医院眼科,200233 [2]上海同济大学附属同济医院眼科,200233

出　　处：《中华眼外伤职业眼病杂志》2014年第5期332-335,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的 评价25G玻璃体腔灌注在玻璃体切除术后的白内障超声乳化手术中的应用效果.方法 采用预置25G玻璃体腔灌注的方法对41例（42只眼）玻璃体切除术后的白内障施行超声乳化联合人工晶状体植入术,观察并记录术后视力、眼压、患者自觉症状、巩膜穿刺口情况及术中、术后并发症.结果 所有手术均顺利完成.术后3个月时,40只眼最佳矫正视力较术前有不同程度提高,最佳矫正视力＞0.1者30只眼,手术前后比较,差别有统计学意义（x2=13.77,P＜0.01）,其中最佳矫正视力≥0.3者20只眼,手术前后比较,差别有统计学意义（x2=12.81,P＜0.01）.2只眼因原有的眼底病复发导致玻璃体积血,视力再度下降.术后1d、1周、末次随访时平均眼压分别为（14.62±0.56） mmHg、（14.82±0.54） mmHg和（14.83±0.57） mmHg,与术前平均眼压（14.86±0.59） mmHg（1 mmHg=0.133 kPa）比较,差别均无统计学意义（t=1.70,0.19,0.40,P＞0.05）.所有患者眼部刺激症状轻微,巩膜穿刺口愈合良好,术中及术后均未见严重并发症发生.结论 在玻璃体切除术后的白内障超声乳化术中,应用25G玻璃体腔灌注有利于维持眼压、稳定前房、减少手术并发症,是一种安全有效的辅助措施.Objective To evaluate the clinical effect of 25-gauge transconjunctival sutureless vitrectomy （25 GT-SV） infusion system in phacoemulsification after pars plana vitrectomy. Methods Under 25GTSV infusion system, phacoemulsification and intraocular lens implantation were performed in 41 cases （42 eyes） of cataract after pars plana vitrectomy. Postoperative visual acuity, intraocular pressure （IOP）, subjective symptoms, scleral incision, intra- and post-operative complications were observed. Results All operations were successfully performed. The best corrected visual acuity （BCVA） of 40 eyes improved in different degrees 3 months after operation. The BCVA was 〉 0. 1 in 30 eyes and there was significant difference between before and after operation （X2 = 13.77, P 〈0.01 ）. The BCVA of 20 eyes was ≥0.3 and there was significant difference between before and after operation （X2 = 12. 81, P 〈 0.01 ）. The visual acuity of 2 eyes decreased because of vitreous hemorrhage caused by original disease of fundus. The mean IOP at 1 day, 1 week after operation and at the end of the follow-up were （ 14.62 ± 0.56） mmHg, （ 14.82 ± O. 54 ） mmHg and （ 14.83 ± 0.57 ） mmHg, respectively. Compared with the mean lOP （ 14.86 ±0.59 ） mmHg （1 mmHg =0. 133 kPa） before surgery, there were no significant differences（t = 1.70,0. 19,0. 40, P 〉 0.05 ）. After operation, the irritation of all eyes was light and the scleral incision was well closed. No obvious complications were observed intraoperatively and postoperatively. Conclusion In phacoemulsification after pars plana vitrectomy, 25G vitreous infusion is a safe and effective method, which can maintain IOP, keep stable anterior chamber and decrease the complications.

关 键 词：灌注 玻璃体腔 25G 白内障 玻璃体切除术后 超声乳化吸出术 

分 类 号：R779.66[医药卫生—眼科]