中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2013年
11期
1465-1467
,共3页
范敏%邹粤丽%韩冬梅%方欣%谭春德%韩新继
範敏%鄒粵麗%韓鼕梅%方訢%譚春德%韓新繼
범민%추월려%한동매%방흔%담춘덕%한신계
超声乳化%手法劈核%超高度近视%并发白内障%人工晶状体
超聲乳化%手法劈覈%超高度近視%併髮白內障%人工晶狀體
초성유화%수법벽핵%초고도근시%병발백내장%인공정상체
Phacoemulsification%Chop technique%Ultra-high myopia%Complicated cataract%Intraocular lens
目的 探讨超声乳化联合手法劈核同时植入人工晶状体治疗超高度近视并发白内障的安全有效性.方法 对于2000年1月至2009年12月在淮南市晨光眼科医院收治的163例172只眼超高度近视并发白内障实施超声乳化联合手法劈核同时植入人工晶状体.术中先用超声乳化头在晶状体中央刻槽,然后将晶状体核旋至前房,以器械劈核后娩出,超声乳化吸除残余碎核,黏弹剂推注清扫后囊膜,植入适度人工晶状体,前房注吸,清除残留物.结果 术后3日,视力0.3～0.6者95只眼,占55.23％,大于0.6者29只眼,占16.86％;术后1个月,视力0.3～0.6者115只眼,占66.86％,大于0.6者36只眼,占20.93％;术中3只眼发生后囊破裂(占1.74％);术后3个月后发生视网膜脱离1只眼(占0.58％),行视网膜复位手术后视力恢复至0.1.结论 使用超声乳化联合手法劈核同时植入人工晶状体治疗高度近视并发白内障,不仅可以减少术中超声乳化能量及乳化时间,从而减轻对角膜内皮的损伤,更重要的是可以减少后囊膜破裂的发生,以及晶状体核坠人玻璃体腔的危险性,提高手术的安全性.同时,低度数人工晶状体的植入可最大限度矫正屈光不正,使患者获得最佳矫正视力.
目的 探討超聲乳化聯閤手法劈覈同時植入人工晶狀體治療超高度近視併髮白內障的安全有效性.方法 對于2000年1月至2009年12月在淮南市晨光眼科醫院收治的163例172隻眼超高度近視併髮白內障實施超聲乳化聯閤手法劈覈同時植入人工晶狀體.術中先用超聲乳化頭在晶狀體中央刻槽,然後將晶狀體覈鏇至前房,以器械劈覈後娩齣,超聲乳化吸除殘餘碎覈,黏彈劑推註清掃後囊膜,植入適度人工晶狀體,前房註吸,清除殘留物.結果 術後3日,視力0.3～0.6者95隻眼,佔55.23％,大于0.6者29隻眼,佔16.86％;術後1箇月,視力0.3～0.6者115隻眼,佔66.86％,大于0.6者36隻眼,佔20.93％;術中3隻眼髮生後囊破裂(佔1.74％);術後3箇月後髮生視網膜脫離1隻眼(佔0.58％),行視網膜複位手術後視力恢複至0.1.結論 使用超聲乳化聯閤手法劈覈同時植入人工晶狀體治療高度近視併髮白內障,不僅可以減少術中超聲乳化能量及乳化時間,從而減輕對角膜內皮的損傷,更重要的是可以減少後囊膜破裂的髮生,以及晶狀體覈墜人玻璃體腔的危險性,提高手術的安全性.同時,低度數人工晶狀體的植入可最大限度矯正屈光不正,使患者穫得最佳矯正視力.
목적 탐토초성유화연합수법벽핵동시식입인공정상체치료초고도근시병발백내장적안전유효성.방법 대우2000년1월지2009년12월재회남시신광안과의원수치적163례172지안초고도근시병발백내장실시초성유화연합수법벽핵동시식입인공정상체.술중선용초성유화두재정상체중앙각조,연후장정상체핵선지전방,이기계벽핵후면출,초성유화흡제잔여쇄핵,점탄제추주청소후낭막,식입괄도인공정상체,전방주흡,청제잔류물.결과 술후3일,시력0.3～0.6자95지안,점55.23％,대우0.6자29지안,점16.86％;술후1개월,시력0.3～0.6자115지안,점66.86％,대우0.6자36지안,점20.93％;술중3지안발생후낭파렬(점1.74％);술후3개월후발생시망막탈리1지안(점0.58％),행시망막복위수술후시력회복지0.1.결론 사용초성유화연합수법벽핵동시식입인공정상체치료고도근시병발백내장,불부가이감소술중초성유화능량급유화시간,종이감경대각막내피적손상,경중요적시가이감소후낭막파렬적발생,이급정상체핵추인파리체강적위험성,제고수술적안전성.동시,저도수인공정상체적식입가최대한도교정굴광불정,사환자획득최가교정시력.
Objective To discuss the safety and efficacy of phacoemulsification combined with chop technique and intraocular lens implantation to treat ultra-high myopia complicated cataract.Methods Phacoemulsification combined with chop technique and intraocular lens implantation was done on 163 cases (172 eyes) of ultra-high myopia complicated cataract.Phaco tip was used to carve groove,then spun the nuclear to the anterior chamber,manually split the nuclear and extracted the nuclear,phacoemulsification broken renmants of the nuclear,injected viscoelastic agent to polish the posterior capsule,implanted suitable intraocular lens,suction the anterior chamber.Results At three days after surgery,eyesight of 95 eyes was 0.3 to 0.6,which occupied 55.23％; the eyesight of 29 eyes above 0.6 occupied 16.86％.At one month after surgery,eyesight of 115 eyes was 0.3 to 0.6,which occupied 66.86％; the eyesight of 36 eyes above 0.6 occupied 20.93％.Three cases occurred posterior capsule rupture intraoperatively (occupied 1.74％).One case occurred retina detachment (occupied 0.58％) at three months postoperative,and visual acuity recovered to 0.1 after retinal reattachment surgery.Conclusions Using phacoemulsification combined with chop technique and intraocular lens implantation to treat ultra-high myopia complicated cataract can not only reduce the intraoperative phacoemulsification energy and duration and reduce corneal endothelium damage,but also reduce the possibility of posterior capsule rupture and the risk of lens nuclear dropping to the vitreous cavity,increase the safety of surgery.Meanwhile,the low diopter of intraocular lens implantation can at the maximum correct the refractive error.
