淮海医药
淮海醫藥
회해의약
JOURNAL OF HUAIHAI MEDICINE
2014年
2期
137-138
,共2页
超声乳化白内障吸除术%高度近视%白内障%人工晶状体
超聲乳化白內障吸除術%高度近視%白內障%人工晶狀體
초성유화백내장흡제술%고도근시%백내장%인공정상체
Phacoemulsification for cataract%High myopia%Cataract%Artificial crystal
目的：观察白内障超声乳化吸除联合人工晶体植入治疗高度近视合并白内障的疗效。方法对46例（65眼），眼轴长度在25.5～32.4mm的高度近视合并白内障患者施行超声乳化摘除，并植入5.5mm折叠式人工晶体。其中眼轴长度25.5～28.5mm39眼（A组），眼轴长度29.0～32.4mm26眼（B组），随访8个月～2年，分别观察术后视力恢复情况及术中术后并发症。结果A组的39眼中，视力恢复≥0.5者33眼（84.6％）；B组的26眼中，视力恢复≥0.5者17眼（65.4％），其中3例患者因白内障较大、较硬，＞Ⅳ级核，改为小切口摘除白内障，并植入人工晶体。2例后囊膜破裂患者均在B组，1例行前玻切后将人工晶体植入睫状沟，术后矫正视力0.5；1例行前玻切，二期行人工晶体睫状沟缝合固定术，术后矫正视力0.3。结论超声乳化摘除白内障联合人工晶体植入术对高度近视合并白内障的治疗安全有效。眼轴短的患者视力恢复总体优于眼轴长的患者；眼轴长的患者出现并发症的几率更大；对于晶状体核较大、较硬者，宜采用小切口摘除联合人工晶体植入的手术方式。
目的：觀察白內障超聲乳化吸除聯閤人工晶體植入治療高度近視閤併白內障的療效。方法對46例（65眼），眼軸長度在25.5～32.4mm的高度近視閤併白內障患者施行超聲乳化摘除，併植入5.5mm摺疊式人工晶體。其中眼軸長度25.5～28.5mm39眼（A組），眼軸長度29.0～32.4mm26眼（B組），隨訪8箇月～2年，分彆觀察術後視力恢複情況及術中術後併髮癥。結果A組的39眼中，視力恢複≥0.5者33眼（84.6％）；B組的26眼中，視力恢複≥0.5者17眼（65.4％），其中3例患者因白內障較大、較硬，＞Ⅳ級覈，改為小切口摘除白內障，併植入人工晶體。2例後囊膜破裂患者均在B組，1例行前玻切後將人工晶體植入睫狀溝，術後矯正視力0.5；1例行前玻切，二期行人工晶體睫狀溝縫閤固定術，術後矯正視力0.3。結論超聲乳化摘除白內障聯閤人工晶體植入術對高度近視閤併白內障的治療安全有效。眼軸短的患者視力恢複總體優于眼軸長的患者；眼軸長的患者齣現併髮癥的幾率更大；對于晶狀體覈較大、較硬者，宜採用小切口摘除聯閤人工晶體植入的手術方式。
목적：관찰백내장초성유화흡제연합인공정체식입치료고도근시합병백내장적료효。방법대46례（65안），안축장도재25.5～32.4mm적고도근시합병백내장환자시행초성유화적제，병식입5.5mm절첩식인공정체。기중안축장도25.5～28.5mm39안（A조），안축장도29.0～32.4mm26안（B조），수방8개월～2년，분별관찰술후시력회복정황급술중술후병발증。결과A조적39안중，시력회복≥0.5자33안（84.6％）；B조적26안중，시력회복≥0.5자17안（65.4％），기중3례환자인백내장교대、교경，＞Ⅳ급핵，개위소절구적제백내장，병식입인공정체。2례후낭막파렬환자균재B조，1례행전파절후장인공정체식입첩상구，술후교정시력0.5；1례행전파절，이기행인공정체첩상구봉합고정술，술후교정시력0.3。결론초성유화적제백내장연합인공정체식입술대고도근시합병백내장적치료안전유효。안축단적환자시력회복총체우우안축장적환자；안축장적환자출현병발증적궤솔경대；대우정상체핵교대、교경자，의채용소절구적제연합인공정체식입적수술방식。
Objective To study the effect of phacoemulsification in treatment of high myopia with cataract .Methods 46 cases (65 eyes) of patients of high myopia with cataract ( ocular axial length 25.5~32.4 mm) underwent phacoemulsification and a 5.5 mm folding artificial crystal was implanted .Two groups were set up:39 eyes (group A) with ocular axial length be-tween 25.5 and 28.5 mm;and 26 eyes (group B) with ocular axial length between 29.0 and 32.4 mm.All the patients were followed up for 8 months to 2 years respectively to observe the postoperative visual acuity as well as intra and post operative complications.Results 33 eyes (84.6%) regained a visual acuity of 0.5 or higher out of 39 eyes in Group A while17 eyes (65.4%) regained a visual acuity of 0.5 or higher out of 26 eyes in Group B.Three of the patients underwent small incision excision to remove cataracts ,followed by implantation of artificial crystal because of their larger and harder cataract (>gradeⅣ) .2 cases of posterior capsular rupture occurred in group B .One underwent vitrectomy along with intraocular lens implanta-tion in the ciliary groove ,with postoperative corrected visual acuity of 0.5;the other underwent IOL ciliary groove suture fixa-tion, with postoperative corrected visual acuity of 0.3.Conclusion Phacoemulsification for the treatment of high myopia with cataract is safe and effective .Patients with short eye axial are generally superior in visual acuity to patients with long axial ,who have a greater risk of complications .Patients with larger and harder lens nucleus should appropriately employ small incisions excision combined intraocular lens implantation surgery .
