中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
CHINESE JOURNAL OF OCULAR TRAUMA AND OCCUPATIONAL EYE DISEASE
2012年
11期
816-819
,共4页
徐蔚%王震%李厚硕%荣翱
徐蔚%王震%李厚碩%榮翱
서위%왕진%리후석%영고
白内障术后%囊袋阻滞综合征%高眼压%前段玻璃体切除%YAG激光
白內障術後%囊袋阻滯綜閤徵%高眼壓%前段玻璃體切除%YAG激光
백내장술후%낭대조체종합정%고안압%전단파리체절제%YAG격광
Post-cataract surgery%Capsular block syndrome%High intraocular pressure%Anterior vitrectomy%YAG laser
目的 探讨白内障行超声乳化联合人工晶状体植入术后因早期囊袋阻滞综合征(CBS)引起持续性高眼压的发病原因、预防及治疗方法.方法 分析54例(54眼)白内障术后早期CBS病例的临床特点,22眼行微创前段玻璃体切除+前房注气术,19眼行YAG激光周边前囊切开或后囊切开术,13眼行降眼压药物治疗.应用SPSS 13.0软件包行单因素方差分析,比较三组处理方式的疗效.结果 3组治疗后1周矫正视力提高,差异无统计学意义(P=0.594),眼压下降,差异有统计学意义(P=0.048).3组随访3个月矫正视力差异无统计学意义(P=0.240),眼压差异有统计学意义(P =0.030),两两组间比较:玻切组和激光组间眼压差异无统计学意义(P =0.725),但分别显著优于药物组(P=0.004,P=0.033).结论 白内障术后早期CBS可以通过扩大撕囊口、选择合适的人工晶状体及提高手术技巧,彻底清除黏弹剂等途径有效预防.在保守治疗无效的情况下,及早行微创前段玻璃体切除+前房注气术,可与激光治疗取得相同疗效,有效降低眼压,提高视力.
目的 探討白內障行超聲乳化聯閤人工晶狀體植入術後因早期囊袋阻滯綜閤徵(CBS)引起持續性高眼壓的髮病原因、預防及治療方法.方法 分析54例(54眼)白內障術後早期CBS病例的臨床特點,22眼行微創前段玻璃體切除+前房註氣術,19眼行YAG激光週邊前囊切開或後囊切開術,13眼行降眼壓藥物治療.應用SPSS 13.0軟件包行單因素方差分析,比較三組處理方式的療效.結果 3組治療後1週矯正視力提高,差異無統計學意義(P=0.594),眼壓下降,差異有統計學意義(P=0.048).3組隨訪3箇月矯正視力差異無統計學意義(P=0.240),眼壓差異有統計學意義(P =0.030),兩兩組間比較:玻切組和激光組間眼壓差異無統計學意義(P =0.725),但分彆顯著優于藥物組(P=0.004,P=0.033).結論 白內障術後早期CBS可以通過擴大撕囊口、選擇閤適的人工晶狀體及提高手術技巧,徹底清除黏彈劑等途徑有效預防.在保守治療無效的情況下,及早行微創前段玻璃體切除+前房註氣術,可與激光治療取得相同療效,有效降低眼壓,提高視力.
목적 탐토백내장행초성유화연합인공정상체식입술후인조기낭대조체종합정(CBS)인기지속성고안압적발병원인、예방급치료방법.방법 분석54례(54안)백내장술후조기CBS병례적림상특점,22안행미창전단파리체절제+전방주기술,19안행YAG격광주변전낭절개혹후낭절개술,13안행강안압약물치료.응용SPSS 13.0연건포행단인소방차분석,비교삼조처리방식적료효.결과 3조치료후1주교정시력제고,차이무통계학의의(P=0.594),안압하강,차이유통계학의의(P=0.048).3조수방3개월교정시력차이무통계학의의(P=0.240),안압차이유통계학의의(P =0.030),량량조간비교:파절조화격광조간안압차이무통계학의의(P =0.725),단분별현저우우약물조(P=0.004,P=0.033).결론 백내장술후조기CBS가이통과확대시낭구、선택합괄적인공정상체급제고수술기교,철저청제점탄제등도경유효예방.재보수치료무효적정황하,급조행미창전단파리체절제+전방주기술,가여격광치료취득상동료효,유효강저안압,제고시력.
Objective To discuss the causes,prevention and treatment of persistent high intraocular pressure caused by early capsular block syndrome (CBS) after phacoemulsification and intraocular lens (IOL) implantation.Methods 54 patients who developed early postoperative CBS were included in this study.22 cases received anterior vitrectomy and anterior chamber gas injection,19 cases received YAG laser anterior or posterior capsulotomy,13 cases only received medication to drop intraocular pressure.Statistical data was analysed by SPSS 13.0 software package to compare the efficacy of treatment.Results The corrected visual acuity improved after one week of treatment,there was no significant difference between the three groups (P =0.594).The high intraocular pressure relieved,there was significant difference (P =0.048).After three months of follow-up,there was no significant difference between the three groups of corrected visual acuity (P =0.240),but there was significant difference of IOP (P =0.030).Furthermore,there was no significant difference of IOP between the vitrectomy group and laser group (P =0.725),but the IOP of the vitrectomy group and laser group was significantly better than that of medication group (P =0.004,P =0.033).Conclusion The early postoperative CBS can be prevented by expansion of capsulorhexis diameter,selecting appropriate intraocular lens,and improving surgical skills to complete removal of the viscoelastic material.When the medication fails,early operation of anterior vitrectomy and anterior chamber gas injection can effectively reduce intraocular pressure and improve corrected visual acuity,which may achieve the same effect of laser treatment.
