玻璃体切割术后眼超声乳化白内障摘出术中并发症的临床分析  

Clinical analysis of intraoperative complications of phacoemulsification in vitrectomized eyes

作　　者：谭娅[1] 周希瑗[1] 徐智勇[1] 王秀青[1] 

机构地区：[1]重庆医科大学附属第二医院眼科,400010

出　　处：《中华实验眼科杂志》2015年第4期373-376,共4页Chinese Journal Of Experimental Ophthalmology

基　　金：重庆市自然科学基金项目（CSTC,2010BB5392）

摘　　要：背景 玻璃体切割术后白内障的发生率增加,而玻璃体切割术后眼行超声乳化白内障摘出术的难度更大,且手术并发症更多.对玻璃体切割术后眼行超声乳化白内障摘出术的并发症进行临床分析有助于减少术中和术后并发症的发生.目的 分析和比较玻璃体切割术后眼行超声乳化白内障摘出术的相关并发症的发生率.方法 纳入2011年1月至2013年11月于重庆医科大学附属第二医院眼科收治的超声乳化白内障摘出术者193例200眼,依据白内障术前是否行玻璃体切割术分为玻璃体切割组及非玻璃体切割组,前者依据患眼是否有硅油亚分为硅油眼组和无硅油眼组.对各组超声乳化白内障摘出术眼的术中并发症进行回顾性分析和比较.结果 玻璃体切割组超声乳化白内障摘出术中后囊膜破裂、悬韧带松弛、瞳孔不易扩大及虹膜弹性差的发生率分别为7.84％、3.92％、1.96％和1.96％,非玻璃体切割组分别为5.37％、0.67％、7.38％和1.34％,2个组间比较差异均无统计学意义（P=0.506、0.160、0.303、1.000）;硅油眼组上述并发症的发生率分别为0.00％、3.57％、3.57％和3.57％,无硅油眼组分别为17.39％、4.35％、0.00％和0.00％,硅油眼组后囊膜破裂的发生率高于无硅油眼组,2个组间的总发生率差异无统计学意义（P=0.442）.非玻璃体切割组、硅油眼组和无硅油眼组术中并发症的总发生率分别为14.77％、10.71％和21.74％,硅油眼组和无硅油眼组与非玻璃体切割组比较,差异均无统计学意义（P=0.770、0.392）.各组均未见虹膜损伤及脉络膜出血.结论 超声乳化白内障摘出术治疗玻璃体切割术后白内障眼的术中并发症发生率与非玻璃体切割术后白内障眼相比无明显增加,但与玻璃体切割术后硅油眼比较,术中无硅油眼的后囊膜更容易破裂,术中应仔细操作.Background The incidence of cataract increases after vitrectomy,and phacoemulsification is a challenge in the cataract eyes following vitrectomy due to the change of ocular anatomy.To analyze the intraoperative complications of phacoemulsification in vitrectomized eyes is significant.Objective This study was to analyze the intraoperative complications of phacoemulsification in vitrectomized eyes.Methods The clinical data of 200 eyes of 193 patients who received phacoemulsification were retrospectively analyzed in Affiliated Second Hospital of Chongqing Medical University from January 2011 to November 2013.Included eyes were grouped to the vitrectomized group and the non-vitrectomy group based on with or without previous pars plana vitrectomy,and then the patients in the vitrectomized group were subgrouped to the silicone oil eye group and the non-silicone oil eye group.The incidence of intraoperative complications of phacoemulsification surgery were compared between different groups.Written informed consent was obtained from each patient prior to any eye surgery.Results The incidence rates of posterior capsule rupture,suspensory ligament relaxation,pupil contraction and poor elasticity of iris were 7.84％,3.92％,1.96％ and 1.96％ in the vitrectomized group,and those in the non-vitrectomy group were 5.37％,0.67％,7.38％ and 1.34％,without significant differences between the two groups （P =0.506,0.160,0.303,1.000）.The complications of mentioned above in turn were 0.00％,3.57％,3.57％ and 3.57％ in the silicon oil group and 17.39％,4.35％,0.00％ and 0.00％ in the without silicon oil group,showing an increased rate in posterior capsule rupture in the silicon oil group,but no significant difference in the total incidence between the two groups （P =0.442）.The total incidence rate in the non-vitrectomy group was 14.77％,and that in the silicon oil eye group was 10.71％,and that in the without silicon oil eye group was 21.74％,no significant differences were found between the non-vitrectomy gro

关 键 词：玻璃体切割术/并发症 白内障/手术 超声乳化白内障摘出术/并发症 晶状体 后囊膜破裂 

分 类 号：R779.6[医药卫生—眼科]