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机构地区:[1]潍坊医学院附属益都中心医院眼科,262500 [2]山东省眼科研究所,青岛266071
出 处:《中华实验眼科杂志》2017年第11期1043-1046,共4页Chinese Journal Of Experimental Ophthalmology
摘 要:角膜病变合并白内障是角膜病医师经常遇到的问题。穿透性角膜移植联合白内障摘出及人工晶状体植入的三联手术,可以避免角膜植片遭受二期白内障手术的损伤,并能快速恢复视力,成为角膜病变合并白内障的主流手术方式。由于角膜移植术后角膜曲率不稳定且角膜形态不规则;导致三联手术后的屈光状态难以预测;而角膜缝线完全拆除后二期行白内障摘出及人工晶状体植入,则可以精确测算人工晶状体的度数以减少术后的屈光误差。因此,也有许多临床医师倾向于先行穿透性角膜移植术,二期行白内障手术。2种手术方式在手术安全性及术后效果等方面各具优势,其选择仍存在争议。近年来,随着眼科显微手术技术的提高及手术器械的发展,对角膜病变合并白内障的手术治疗策略有了新认识,本文就其研究进展作一综述。Corneal lesion with cataract is a problem that corneal disease doctors often encounter. Triple procedure does not need a second operation,which can avoid corneal grafts damage and restore visual acuity quickly, thus it becomes the primary surgical method of corneal lesions with cataracts. But due to the unstable cornea curvature and irregular cornea topography after corneal transplantation, it is difficult to predict the refractive status after triple procedure. Conversely,we can accurately measure the degree of intraocular lens to reduce the refractive error after operation if we perform cataract extraction and intraocular lens implantation after corneal suture was completely removed. Accordingly, there are also many ophthalmic surgeons tend to operate penetrating keratoplasty firstly and cataract surgery laterly. The two kinds of operations have their own advantages on operation safety and postoperative effect, so the choice of operation has been controversial. In recent years, with improvement of ophthalmology microsurgery technology and development of surgical instruments, we have a new understanding on the surgical treatment strategy of the disease. Therefore, recent advances of surgical therapy for the disease are reviewed in this paper.
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