中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2010年
5期
83-85
,共3页
颜志超%骆荣江%李小敏%刘韶瑞%卓业鸿%田臻
顏誌超%駱榮江%李小敏%劉韶瑞%卓業鴻%田臻
안지초%락영강%리소민%류소서%탁업홍%전진
手术改良%硬核白内障%青光眼
手術改良%硬覈白內障%青光眼
수술개량%경핵백내장%청광안
Improved operation%Sclerotic nucleus cataract%Glaucoma
目的 观察青光眼滤过术后硬核性白内障改良手术方式的临床效果.方法 对青光眼小梁切除术后半年以上的硬核性白内障患者共82例(114眼)行颞侧角膜缘反眉弓板层巩膜隧道切口,开罐式破囊,水分离,用注水晶状体圈匙缓慢娩出晶体核,对有虹膜后粘连者进行分离,对瞳孔变形和散大者用0/10线进行瞳孔缝合成形.术中不做直肌牵引缝线和烧灼止血,避开滤过泡,整个手术过程均在密闭状态下完成.术后随访6～12个月,观察术后视力、眼压、滤过泡和并发症等.结果 ①110眼术后视力均有不同程度的提高,视力≥0.6者34眼(占29.82%);0.4～0.6者47眼(占41.23%);0.2～0.4者27眼(占23.68%);≤0.2者6眼(占5.26%);②术眼滤过泡保存完好,未出现滤过泡破损及粘连等情况;③术后瞳孔成形效果好,41眼的瞳孔上移、散大和变形得到改善;④术后眼压保持稳定,所有患者眼压均在8～20 mm Hg(平均为15.15±2.78 mm Hg)范围内,与术前眼压(平均15.23±2.87 mm Hg)比较,差异无统计学意义(t=0.21,P＞0.05);⑤术后有38眼出现不同程度的角膜水肿,3眼出现较为严重的葡萄膜炎性反应,经治疗后均逐渐消退.结论 采用本法改良的术式对青光眼滤过术后硬核性白内障施行摘除手术的疗效较好且操作简单、便于推广.
目的 觀察青光眼濾過術後硬覈性白內障改良手術方式的臨床效果.方法 對青光眼小樑切除術後半年以上的硬覈性白內障患者共82例(114眼)行顳側角膜緣反眉弓闆層鞏膜隧道切口,開罐式破囊,水分離,用註水晶狀體圈匙緩慢娩齣晶體覈,對有虹膜後粘連者進行分離,對瞳孔變形和散大者用0/10線進行瞳孔縫閤成形.術中不做直肌牽引縫線和燒灼止血,避開濾過泡,整箇手術過程均在密閉狀態下完成.術後隨訪6～12箇月,觀察術後視力、眼壓、濾過泡和併髮癥等.結果 ①110眼術後視力均有不同程度的提高,視力≥0.6者34眼(佔29.82%);0.4～0.6者47眼(佔41.23%);0.2～0.4者27眼(佔23.68%);≤0.2者6眼(佔5.26%);②術眼濾過泡保存完好,未齣現濾過泡破損及粘連等情況;③術後瞳孔成形效果好,41眼的瞳孔上移、散大和變形得到改善;④術後眼壓保持穩定,所有患者眼壓均在8～20 mm Hg(平均為15.15±2.78 mm Hg)範圍內,與術前眼壓(平均15.23±2.87 mm Hg)比較,差異無統計學意義(t=0.21,P＞0.05);⑤術後有38眼齣現不同程度的角膜水腫,3眼齣現較為嚴重的葡萄膜炎性反應,經治療後均逐漸消退.結論 採用本法改良的術式對青光眼濾過術後硬覈性白內障施行摘除手術的療效較好且操作簡單、便于推廣.
목적 관찰청광안려과술후경핵성백내장개량수술방식적림상효과.방법 대청광안소량절제술후반년이상적경핵성백내장환자공82례(114안)행섭측각막연반미궁판층공막수도절구,개관식파낭,수분리,용주수정상체권시완만면출정체핵,대유홍막후점련자진행분리,대동공변형화산대자용0/10선진행동공봉합성형.술중불주직기견인봉선화소작지혈,피개려과포,정개수술과정균재밀폐상태하완성.술후수방6～12개월,관찰술후시력、안압、려과포화병발증등.결과 ①110안술후시력균유불동정도적제고,시력≥0.6자34안(점29.82%);0.4～0.6자47안(점41.23%);0.2～0.4자27안(점23.68%);≤0.2자6안(점5.26%);②술안려과포보존완호,미출현려과포파손급점련등정황;③술후동공성형효과호,41안적동공상이、산대화변형득도개선;④술후안압보지은정,소유환자안압균재8～20 mm Hg(평균위15.15±2.78 mm Hg)범위내,여술전안압(평균15.23±2.87 mm Hg)비교,차이무통계학의의(t=0.21,P＞0.05);⑤술후유38안출현불동정도적각막수종,3안출현교위엄중적포도막염성반응,경치료후균축점소퇴.결론 채용본법개량적술식대청광안려과술후경핵성백내장시행적제수술적료효교호차조작간단、편우추엄.
Objective To observe the therapeutic effect of extracapsular cataract extraction of Ⅳ/Ⅴ grade sclerotic cataract with IOL implantation after glaucoma trabeculectomy through a small incisions.Methods Eighty-two cases(114 eyes)of Ⅳ/Ⅴ grade sclerotic cataract accepted cataract extraction through an anti-superciliary arch temporal corneal limbus lamellar scleral tunnel incision with IOL implantation after glaucoma trabeculectomy for more than half a year.Follow up 6-12 months.The postoperative vision,IOP,filtrate bleb and complications were observed.Results The postoperative vision were improved in 82 cases(114eyes) ,in which 34 eyes' (29.82%) vision ≥ 0.6,47 eyes' (41.23%) 0.4-0.6,27 eyes' (23.68%) 0.2-0.4,6 eyes'(5.26%) ≤0.2.The postoperative filtrate blebs were well-preserved and the pupils forming effective,41 of the pupils on the move,mydriasis and deformation were improved.The postoperative average IOP was(15.15 ±2.78)mm Hg(1 mm Hg = 0.133 KPa) ,and it was no statistically significant differences in pre-or post-operative intraocular pressure(t'= 0.21 ,P ＞ 0.05).There were 38 eyes with corneal edema and 3 eyes with uveitis after improved surgery.Conclusion This operative technique is effective to treat sclerotic cataract after glaucoma surgery.,which is simple and easy to promote.
