玻璃体切除术后透明角膜切口白内障超声乳化术

Cataract Phacoemulsification after Vitrectomy for Transparent Corneal Incision

摘要: 目的：探讨玻璃体切除术后白内障的手术技巧以及并发症的处理。方法：行过玻璃体切除术的白内障患者19人19眼。在表面麻醉下行透明角膜切口的超声乳化术，未用辅助灌注，并I期植入人工晶体，包扎术眼。常规第2天开放滴眼。随访2~12个月。结果：1) 术中前房：19眼前房均明显加深，个别前房极深。2) 视力：视力提高 > 3行的6眼，视力无改善的1眼，视力提高 < 3行者12眼。3) 术后眼压：术后随访1月，眼压在9~23 mmHg。4) 并发症：角膜水肿6眼，无角膜失代偿；前房炎症反应、闪辉7眼；无后囊破裂及核块坠入玻璃体腔。结论：对白内障超声乳化手术技巧和术者的操作均提出了更高的要求。其术者必须具备丰富的内眼手术经验，娴熟的超声乳化技术，并具有较强的风险预判和应变能力，以及良好的心理素质。可以取得很好的手术效果。

Abstract: Objective: To investigate the surgical technique of cataract after vitrectomy and the treatment of complications. Methods: There are 19 eyes of 19 cataract patients underwent vitrectomy, phacoemulsification of transparent corneal incisions on surface anesthesia, without auxiliary perfusion, and implantation of intraocular lens, Regular second day open eye drops. The follow-up is 2 - 12 months. Results: 1) Anterior chamber during the operation: anterior chamber was signif-icantly deepened, and the individual Anterior chamber was extremely deep. 2) Postoperative visual acuity: visual acuity improved > 3 line 6 eyes, visual acuity did not improve 1 eye, visual acuity improved < 3 walker 12 eyes. 3) Postoperative intraocular pressure: postoperative follow-up of 1 month, with an intraocular pressure of 9 - 23 mmHg. 4) Complications: 6 eyes with corneal edema, no corneal decompensation; 7 eyes were anterior chamber inflammation and flash; there was no the posterior capsular rupture and the nuclear block fall into the vitreous cavity. Conclusion: The surgical technique of phacoemulsification and operation of cataract are more demanding. The pa-tient must have rich experience of intraocular operation, skilled technology of phacoemulsification, strong risk prediction and strain ability, and good psychological quality. It can be very effective.