国际眼科杂志
國際眼科雜誌
국제안과잡지
INTERNATIONAL JOURNAL OF OPHTHALMOLOGY
2014年
9期
1627-1629
,共3页
张怡%张帆%吐尔洪江·麦麦提%迪丽努尔·卡斯木%蒋永祥
張怡%張帆%吐爾洪江·麥麥提%迪麗努爾·卡斯木%蔣永祥
장이%장범%토이홍강·맥맥제%적려노이·잡사목%장영상
剥脱综合征%白内障%超声乳化%青光眼%囊袋张力环
剝脫綜閤徵%白內障%超聲乳化%青光眼%囊袋張力環
박탈종합정%백내장%초성유화%청광안%낭대장력배
exfoliation syndrome%cataract%phacoemulsification%glaucoma%capsular tension ring
目的：探讨囊袋张力环(capsulartensionring,CTR)植入联合超声乳化人工晶状体(intraocularlens,IOL)植入术治疗剥脱综合征性青光眼术后白内障的安全性和有效性。<br> 方法：回顾性分析2012-01/2013-06对连续性收治的剥脱综合征性青光眼小梁切除术后白内障10例10眼行超声乳化白内障摘除联合CTR及IOL植入术,Ⅱ级核1眼,Ⅲ级核4眼,Ⅳ级核5眼,其中Ⅳ级核合并虹膜、晶状体震颤1眼。分析术后裸眼及矫正视力、术中术后并发症、前囊撕囊口、IOL位置、术后眼压情况。随访3~14mo。<br> 结果：所有患者均安全实施超声乳化白内障摘除、囊袋张力环及IOL植入术。其中改良悬吊双钩CTR1眼,标准CTR9眼。术眼矫正视力≥0.5者3眼,0.3~者2眼,≤0.1者5眼,所有患者均IOL无偏位,眼底均有不同程度的视神经萎缩。术前平均眼压16.78±2.48mmHg,术后3mo平均眼压16.01±2.33mmHg(t=1.9955,P<0.05)。术中术后最常见并发症为角膜水肿、瞳孔散不大、皮质残留、悬韧带松弛。<br> 结论：剥脱综合征性青光眼小梁切除术后并发白内障,选择合适类型和合适时机的CTR植入可提高超声乳化手术安全性,防止IOL偏位,减少手术并发症的发生,早期手术并发症更少。
目的：探討囊袋張力環(capsulartensionring,CTR)植入聯閤超聲乳化人工晶狀體(intraocularlens,IOL)植入術治療剝脫綜閤徵性青光眼術後白內障的安全性和有效性。<br> 方法：迴顧性分析2012-01/2013-06對連續性收治的剝脫綜閤徵性青光眼小樑切除術後白內障10例10眼行超聲乳化白內障摘除聯閤CTR及IOL植入術,Ⅱ級覈1眼,Ⅲ級覈4眼,Ⅳ級覈5眼,其中Ⅳ級覈閤併虹膜、晶狀體震顫1眼。分析術後裸眼及矯正視力、術中術後併髮癥、前囊撕囊口、IOL位置、術後眼壓情況。隨訪3~14mo。<br> 結果：所有患者均安全實施超聲乳化白內障摘除、囊袋張力環及IOL植入術。其中改良懸弔雙鉤CTR1眼,標準CTR9眼。術眼矯正視力≥0.5者3眼,0.3~者2眼,≤0.1者5眼,所有患者均IOL無偏位,眼底均有不同程度的視神經萎縮。術前平均眼壓16.78±2.48mmHg,術後3mo平均眼壓16.01±2.33mmHg(t=1.9955,P<0.05)。術中術後最常見併髮癥為角膜水腫、瞳孔散不大、皮質殘留、懸韌帶鬆弛。<br> 結論：剝脫綜閤徵性青光眼小樑切除術後併髮白內障,選擇閤適類型和閤適時機的CTR植入可提高超聲乳化手術安全性,防止IOL偏位,減少手術併髮癥的髮生,早期手術併髮癥更少。
목적：탐토낭대장력배(capsulartensionring,CTR)식입연합초성유화인공정상체(intraocularlens,IOL)식입술치료박탈종합정성청광안술후백내장적안전성화유효성。<br> 방법：회고성분석2012-01/2013-06대련속성수치적박탈종합정성청광안소량절제술후백내장10례10안행초성유화백내장적제연합CTR급IOL식입술,Ⅱ급핵1안,Ⅲ급핵4안,Ⅳ급핵5안,기중Ⅳ급핵합병홍막、정상체진전1안。분석술후라안급교정시력、술중술후병발증、전낭시낭구、IOL위치、술후안압정황。수방3~14mo。<br> 결과：소유환자균안전실시초성유화백내장적제、낭대장력배급IOL식입술。기중개량현조쌍구CTR1안,표준CTR9안。술안교정시력≥0.5자3안,0.3~자2안,≤0.1자5안,소유환자균IOL무편위,안저균유불동정도적시신경위축。술전평균안압16.78±2.48mmHg,술후3mo평균안압16.01±2.33mmHg(t=1.9955,P<0.05)。술중술후최상견병발증위각막수종、동공산불대、피질잔류、현인대송이。<br> 결론：박탈종합정성청광안소량절제술후병발백내장,선택합괄류형화합괄시궤적CTR식입가제고초성유화수술안전성,방지IOL편위,감소수술병발증적발생,조기수술병발증경소。
To investigate the safety and efficacy of capsular tension ring ( CTR ) insertion combined with phacoemulsification and intraocular lens ( lOL ) implantation in patient with pseudoexfoliation syndrome after anti-glaucoma surgery. <br> ●METHODS: A retrospective study was conducted of 10 eyes from 10 cataract patients with pseudoexfoliation syndrome following trabeculectomy surgery, and who underwent CTR insertion combined with phacoemulsification and lOL implantation between January, 2012 and June, 2013. All cases had nuclear cataracts ( nuclear hardness Ⅱ 1 eye, nuclear hardnessⅢ 4 eyes, nuclear hardness Ⅳ 5 eyes). One case with Ⅳ nuclear hardness cataract had iridodonesis and lens subluxation. Postoperative visual acuity, intra- and post-operative complications, anterior capsular opening, lOL position, and postoperative intraocular pressure ( lOP) were assessed. Follow-ups ranged from 3 to 14mo. The t test was used to analyze the variables studied. <br> ●RESULTS: All patients had a successful CTR insertion combined with phacoemulsification and lOL implantation. A modified CTR insertion was performed in one case, the others underwent a standard CTR insertion. The best corrected visual acuity ( BCVA) was≥0. 5 in 3 eyes and 0. 3-<0. 5 in 2 eyes. However, BCVA was ≤0. 1 in 5 eyes. No decentration and dislocation of lOL was found during follow - up. Optic atrophy of different level could be found in all cases. The mean lOP was 16. 78±2. 48mmHg before surgery. And the average lOP is 16. 01±2. 33mmHg at 3mo postoperative (t= 1. 9955, P>0. 05). The most common intrao- and post-operative complications were corneal edema, small pupil, residual cortex, spontaneous zonular dialysis. <br> ● CONCLUSlON: Suitable CTR insertion in appropriate occasion may be beneficial to patients with pseudoexfoliation syndrome after trabeculectomy during cataract surgery. lt prevents the lOL decentration and decrease the surgical complication. Less complication occurs at the early stage.
