CAJ | 학술논문

目的研究总结经睫状体平坦部穿刺抽吸玻璃体液在眼前节内眼手术中突发玻璃体正性压力下应用的经验,为眼科手术医师在眼前节内眼手术时面对玻璃体正性压力进行此操作提供参考.方法回顾性临床研究.收集2010年12月至2012年3月在西安市第四医院眼科行眼前节内眼手术中进行经睫状体平坦部穿刺抽吸玻璃体液患者24例(25例次),其中1例患者前后2次手术均进行了经睫状体平坦部穿刺抽吸玻璃体液.分析此类患者性别、平均年龄、术前诊断、手术方式、术前术后眼压、穿刺时机及穿刺相关并发症.结果进行经睫状体平坦部穿刺抽吸玻璃体液患者的男女比为1:2；平均年龄是(60.0±10.4)岁；所有穿刺患者中第一诊断青光眼21例,白内障4例；其中14例行抗青光眼手术,3例行白内障超声乳化人工晶状体植入手术,其余患者中白内障超声乳化联合前部玻璃体切割4例,白内障超声乳化联合全玻璃体切割1例,青白联合及前部玻璃体切割3例.所有患者术前联合最大量降眼压药物后平均眼压为(32.50±13.41) mm Hg,术后第一天平均眼压为(21.95±10.69) mm Hg;经睫状体平坦部穿刺在手术步骤的各个阶段都可能实施.有2例出现并发症,1例出现少量玻璃体腔积血,1例出现后囊膜破裂.结论玻璃体正性压力是眼前节内眼手术中偶尔可见的棘手问题,经睫状体平坦部玻璃体腔穿刺可以迅速解除临床症状,使手术操作转危为安.此项操作存在一定风险,眼科手术医师应注意操作,减少并发症的发生.
목적 연구총결경첩상체평탄부천자추흡파리체액재안전절내안수술중돌발파리체정성압력하응용적경험,위안과수술의사재안전절내안수술시면대파리체정성압력진행차조작제공삼고.방법 회고성림상연구.수집2010년12월지2012년3월재서안시제사의원안과행안전절내안수술중진행경첩상체평탄부천자추흡파리체액환자24례(25례차),기중1례환자전후2차수술균진행료경첩상체평탄부천자추흡파리체액.분석차류환자성별、평균년령、술전진단、수술방식、술전술후안압、천자시궤급천자상관병발증.결과 진행경첩상체평탄부천자추흡파리체액환자적남녀비위1:2；평균년령시(60.0±10.4)세；소유천자환자중제일진단청광안21례,백내장4례；기중14례행항청광안수술,3례행백내장초성유화인공정상체식입수술,기여환자중백내장초성유화연합전부파리체절할4례,백내장초성유화연합전파리체절할1례,청백연합급전부파리체절할3례.소유환자술전연합최대량강안압약물후평균안압위(32.50±13.41) mm Hg,술후제일천평균안압위(21.95±10.69) mm Hg;경첩상체평탄부천자재수술보취적각개계단도가능실시.유2례출현병발증,1례출현소량파리체강적혈,1례출현후낭막파렬.결론 파리체정성압력시안전절내안수술중우이가견적극수문제,경첩상체평탄부파리체강천자가이신속해제림상증상,사수술조작전위위안.차항조작존재일정풍험,안과수술의사응주의조작,감소병발증적발생.
Objective To summary the clinical practice experience of pars plana anterior vitreous aspiration during intraocular operation of ocular anterior segment,to give suggestion to ophthalmologist in front of positive vitreous pressure.Methods A retrospective clinical study.The data of 24 patients (25 cases) who received pars plana anterior vitreous aspiration during intraocular operation of ocular anterior segment from December 2010 to March 2012 in Xi' an NO.4 hospital were collected.One of them had this practice in two time operations.Analysis the patients' sex,average age,preoperative diagnosis,operation mode,preoperative and postoperative intraocular pressure,puncture time,puncture related complications.Results The ratio of male and female was 1:2; average age was 60.0±10.4; in all cases,the first diagnosis was glaucoma in 21 cases,4 cases was cataract;the operation mode included:14 cases with glaucoma surgery,3 cases underwent phacoemulsification,4 cases underwent phacoemulsification combined with anterior vitrectomy,1 case underwent phacoemulsification combined with pars plana vitretomy,3 cases underwent anti-glaucoma and phacoemulsification combined with anterior vitrectomy; the average intraocular pressure of those cases with maximum drugs was 32.50±13.41mmHg,average intraocular pressure was 21.95±10.69 mmHg within the first day of postoperative; par plana anterior vitreous aspiration was likely to practice in any operation steps; two cases had complication,one was little vitreous hemorrhage,one was posterior capsular rupture.Conclusions Positive vitreous pressure is an occasionally thorny issue during intraocular operation in ocular anterior segment.Pars plana anterior vitreous aspiration can be quickly relieved clinical symptoms,make operation turn the comer.The clinical practice have some risk,ophthalmic should pay attention to operation and reduce complications.