CAJ | 학술논문

目的：观察高速玻璃体切割系统在白内障超声乳化手术联合后段玻璃体切割手术中的应用效果。方法2012年10月至2013年3月收治的60岁以上且有Ⅱ级以上晶状体浑浊伴玻璃体视网膜疾病患者81例（86眼），采用高速玻璃体切割系统行前后节联合手术。其中男性43例（46眼），女性38例（40眼），平均年龄（72.1±10.5）岁（60～83岁）。患者术前均行眼科常规检查、 A／B超声检查及人工晶体度数测定。患者行23 G微创切口穿刺后，先闭合眼内灌注，行白内障超声乳化及人工晶体植入术，保留前房粘弹剂，行Resight非接触式广角镜系统下高速玻璃体切割，术后行硅油或C3 F8或眼内灌注液填充。观察患者视力改善状况、眼底情况及手术后并发症发生的情况。结果所有患者顺利完成手术，平均手术时间（48.0±12.6） min （35～65 min ）。86只眼中，术后视力提高者80只眼（93.0％），不变者5只眼（5.8％），视力下降者1只眼（1.2％）。术后角膜水肿者10只眼（11.6％），前房反应25只眼（29.1％），经对症处理1周后均明显缓解。无其他并发症发生。结论对于有Ⅱ级以上晶状体浑浊且需要行玻璃体切割手术的老年白内障患者，釆用高速玻璃体切割并联合超声乳化人工晶体植入，可在术后快速提高视力，且较少发生并发症。
목적：관찰고속파리체절할계통재백내장초성유화수술연합후단파리체절할수술중적응용효과。방법2012년10월지2013년3월수치적60세이상차유Ⅱ급이상정상체혼탁반파리체시망막질병환자81례（86안），채용고속파리체절할계통행전후절연합수술。기중남성43례（46안），녀성38례（40안），평균년령（72.1±10.5）세（60～83세）。환자술전균행안과상규검사、 A／B초성검사급인공정체도수측정。환자행23 G미창절구천자후，선폐합안내관주，행백내장초성유화급인공정체식입술，보류전방점탄제，행Resight비접촉식엄각경계통하고속파리체절할，술후행규유혹C3 F8혹안내관주액전충。관찰환자시력개선상황、안저정황급수술후병발증발생적정황。결과소유환자순리완성수술，평균수술시간（48.0±12.6） min （35～65 min ）。86지안중，술후시력제고자80지안（93.0％），불변자5지안（5.8％），시력하강자1지안（1.2％）。술후각막수종자10지안（11.6％），전방반응25지안（29.1％），경대증처리1주후균명현완해。무기타병발증발생。결론대우유Ⅱ급이상정상체혼탁차수요행파리체절할수술적노년백내장환자，변용고속파리체절할병연합초성유화인공정체식입，가재술후쾌속제고시력，차교소발생병발증。
Objective To observe the application of high-speed vitrectomy system in combined surgery of phacoemulsification and vitrectomy .Methods Eighty-one patients (86 eyes) aged over 60 years with degree Ⅱlens opacity and vitreous retinal disorders treated between October 2012 and March 2013 were enrolled .The pa-tients included 43 males (46 eyes) and 38 females (40 eyes), at a mean age of (72.1 ±10.5) years (60-83 years).All the patients received routine ophthalmological examination , A/B mode ultrasound, and intraocular lens degree testing .With a 23G minimally invasive incision , phacoemulsification and intraocular lens implanta-tion were performed after closed the intraocular perfusion .With the viscoelastic agent left in the anterior cham-ber, high-speed vitrectomy was conducted using Resight noncontact wide -angle lens system , finished by filling with silicone oil , C3 F8 , or intraocular infusion fluid .Visual acuity , fundus condition , and postoperative compli-cations of the patients were observed .Results The combined surgery was successfully performed in all the pa-tients, with a mean operation time of (48.0 ±12.6) minutes (35-65 minutes).Among the 86 eyes, vision was improved in 80 eyes (93.0%), unchanged in 5 eyes (5.8%), and deteriorated in 1 eye (1.2%).After the surgery , 10 eyes (11.6%) developed corneal edema , and 25 (29.1%) showed anterior chamber reaction , all mitigated by treatment after 1 week.No other complications were reported .Conclusions For the elderly pa-tients with degree II lens opacity and the need of vitrectomy , the high-speed vitrectomy combined with phacoemul-sification and intraocular lens implantation can rapidly improve eyesight and reduce the incidence of postoperative complications .