中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
2013年
4期
214-217
,共4页
超声乳化白内障吸除术%人工晶状体%瞳孔夹持%囊袋阻滞%瞳孔阻滞型高眼压症
超聲乳化白內障吸除術%人工晶狀體%瞳孔夾持%囊袋阻滯%瞳孔阻滯型高眼壓癥
초성유화백내장흡제술%인공정상체%동공협지%낭대조체%동공조체형고안압증
Phacoemulsication%Intraocular lens%Pupillary capture%Capsular block syndrome%Pupillary block high intraocular pressure
目的 探讨白内障超声乳化人工晶状体(IOL)植入术后急性瞳孔阻滞型高眼压症的原因和处理方法.方法 回顾性病例研究.2000年1月至2011年12月期间在台州市眼科医院行白内障超声乳化术后早期由于瞳孔阻滞所致的急性高眼压症者17例(17眼),其中IOL瞳孔夹持所致5例,囊袋阻滞综合征(CBS)所致12例.对IOL瞳孔夹持所致的5例采用复方托吡卡胺眼药水散瞳和静脉滴注20％甘露醇浓缩玻璃体治疗.对CBS所致的12例,其中行Nd:YAG激光前囊孔边缘切开2例和前囊周边部切开5例;手术行前囊孔边缘放射状切开2例和补充扩大前囊口直径3例,并作前房及囊袋冲洗.观察处理后的眼压、视力、IOL位置、前房和囊袋情况.结果 术后随访2～3个月,所有术眼瞳孔阻滞消失,眼压正常,视力提高,前房加深,IOL位置正常.IOL瞳孔夹持所致的5眼末次随访时眼压为11～19 mmHg,平均(15.0±4.0) mmHg.最佳矫正视力为0.7～1.0.CBS所致的12眼末次随访时眼压为12～18 mmHg,平均(15.0±3.0)mmHg.最佳矫正视力为0.8～1.0.结论 IOL瞳孔夹持和CBS可以引起白内障超声乳化术后早期瞳孔阻滞型急性高眼压症.对IOL瞳孔夹持者采用散瞳,对CBS所致者行Nd:YAG激光或手术治疗,均可有效解除其所致的高眼压.
目的 探討白內障超聲乳化人工晶狀體(IOL)植入術後急性瞳孔阻滯型高眼壓癥的原因和處理方法.方法 迴顧性病例研究.2000年1月至2011年12月期間在檯州市眼科醫院行白內障超聲乳化術後早期由于瞳孔阻滯所緻的急性高眼壓癥者17例(17眼),其中IOL瞳孔夾持所緻5例,囊袋阻滯綜閤徵(CBS)所緻12例.對IOL瞳孔夾持所緻的5例採用複方託吡卡胺眼藥水散瞳和靜脈滴註20％甘露醇濃縮玻璃體治療.對CBS所緻的12例,其中行Nd:YAG激光前囊孔邊緣切開2例和前囊週邊部切開5例;手術行前囊孔邊緣放射狀切開2例和補充擴大前囊口直徑3例,併作前房及囊袋遲洗.觀察處理後的眼壓、視力、IOL位置、前房和囊袋情況.結果 術後隨訪2～3箇月,所有術眼瞳孔阻滯消失,眼壓正常,視力提高,前房加深,IOL位置正常.IOL瞳孔夾持所緻的5眼末次隨訪時眼壓為11～19 mmHg,平均(15.0±4.0) mmHg.最佳矯正視力為0.7～1.0.CBS所緻的12眼末次隨訪時眼壓為12～18 mmHg,平均(15.0±3.0)mmHg.最佳矯正視力為0.8～1.0.結論 IOL瞳孔夾持和CBS可以引起白內障超聲乳化術後早期瞳孔阻滯型急性高眼壓癥.對IOL瞳孔夾持者採用散瞳,對CBS所緻者行Nd:YAG激光或手術治療,均可有效解除其所緻的高眼壓.
목적 탐토백내장초성유화인공정상체(IOL)식입술후급성동공조체형고안압증적원인화처리방법.방법 회고성병례연구.2000년1월지2011년12월기간재태주시안과의원행백내장초성유화술후조기유우동공조체소치적급성고안압증자17례(17안),기중IOL동공협지소치5례,낭대조체종합정(CBS)소치12례.대IOL동공협지소치적5례채용복방탁필잡알안약수산동화정맥적주20％감로순농축파리체치료.대CBS소치적12례,기중행Nd:YAG격광전낭공변연절개2례화전낭주변부절개5례;수술행전낭공변연방사상절개2례화보충확대전낭구직경3례,병작전방급낭대충세.관찰처리후적안압、시력、IOL위치、전방화낭대정황.결과 술후수방2～3개월,소유술안동공조체소실,안압정상,시력제고,전방가심,IOL위치정상.IOL동공협지소치적5안말차수방시안압위11～19 mmHg,평균(15.0±4.0) mmHg.최가교정시력위0.7～1.0.CBS소치적12안말차수방시안압위12～18 mmHg,평균(15.0±3.0)mmHg.최가교정시력위0.8～1.0.결론 IOL동공협지화CBS가이인기백내장초성유화술후조기동공조체형급성고안압증.대IOL동공협지자채용산동,대CBS소치자행Nd:YAG격광혹수술치료,균가유효해제기소치적고안압.
Objective To study the causes of acute high intraocular pressure (HIOP) caused by pupillary block after phacoemulsification with intraocular lens (IOL) implantation and the treatments to manage the condition.Methods Seventeen patients (17 eyes) with early postoperative acute HIOP caused by pupillary block who underwent cataract phacoemulsification with IOL implantation in Taizhou Eye Hospital between January 2000 and December 2011 were retrospectively analyzed.Among the 17 cases,5 cases were caused by onset IOL pupillary capture and 12 cases by capsular block syndrome (CBS).Conservative approaches were adopted that included tropicamide phenylephrine eye drops for mydriasis and 250 ml of intravenous drip with 20％ mannital to the concentrated vitreous for the 5 cases of acute pupillary block HIOP caused by onset IOL pupillary capture.For the other 12 cases with CBS,Nd:YAG laser was used for anterior capsulotomy to cut the margin of the continuous circular capsulorhexis (CCC) in 2 cases and anterior peripheral capsulotomy was performed in 5 cases.Radialization was performed surgically to cut the margin of the CCC in 2 cases and supplied the CCC to enlarge the diameter in 3 cases.And finally,aspiration-irrigation was performed to flush the anterior chamber and the capsule.Intraocular pressure (IOP),visual acuity,position of IOL,and the conditions of the anterior chamber and capsule were measured after treatment.Results The patients were followed up for 2-3 months after treatment.Pupillary block disappeared,IOP was normal,visual acuity improved,the anterior chamber deepened and the position of the IOL was normal in all operated eyes.At the last follow-up,IOP was 11-19 mmHg (mean 0.85±0.15 mmHg)and best corrected visual acuity (BCVA) was 0.7-1.0 in 5 cases with IOL pupillary capture.IOP was 12-18 mmHg (mean 15±3.0 mmHg) and BCVA was 0.8-1.0 in 12 cases with CBS.Conclusion IOL pupillary capture and CBS can that induces acute pupillary block HIOP.Applying mydriasis can effectively resolve acute pupillary block HIOP caused by the IOL pupillary capture.Using ND:YAG laser and operation are the effective measures to treat acute pupillary block HIOP caused by CBS.
