1.8mm同轴微切口超声乳化白内障手术联合玻璃体切割术的应用

发布时间：2019-06-05 03:35

【摘要】：目的分析1.8 mm同轴微切口超声乳化白内障手术在眼前后节联合手术中的优势及应用价值。方法回顾性分析1.8 mm同轴微切口超声乳化白内障联合玻璃体切割术57例(57眼)患者的临床资料,术中微切口超声乳化白内障完成后仅作水密封角膜切口,眼后节手术操作结束时,根据预后评估及后续治疗方案决定是否人工晶状体植入和硅油填充,需要Ⅰ期植入人工晶状体者,3.0 mm穿刺刀扩大主切口,囊袋内植入可折叠人工晶状体1枚,观察术后视力改善情况及术中、术后早期、远期并发症,随访1~24个月。结果 57眼手术均顺利完成,术中均无角膜切口渗漏、前房消失及后囊膜破裂发生,气-液交换时前房出现气泡1眼。人工晶状体植入且硅油填充10眼,人工晶状体植入但未硅油填充15眼,硅油填充但未人工晶状体植入32眼。术后视力较术前改善51眼(89.5%),视力不变6眼(10.5%),术后早期一过性低眼压2眼(3.5%)。末次随访时手术切口均密闭良好,前房中深,晶状体缺如或人工晶状体在位,无人工晶状体夹持及移位发生。结论在眼前后节联合手术中,1.8mm同轴微切口超声乳化白内障手术角膜切口无需缝合,术中前房稳定,手术安全,具有较高的应用价值,且随着人工晶状体的发展和经济水平的提高,选用微切口超声乳化白内障手术方法值得临床推广使用。
[Abstract]:Objective to analyze the advantages and application value of 1.8 mm coaxial microincision phacoemulsification in anterior and posterior segment surgery. Methods the clinical data of 57 patients (57 eyes) with 1.8 mm coaxial microincision phacoemulsification combined with vitrification were analyzed retrospectively. only water sealed corneal incision was made after intraoperative microincision phacoemulsification. At the end of posterior segment surgery, the intraocular lens implantation and silicone oil filling were determined according to the prognosis evaluation and follow-up treatment plan, and the main incision was enlarged by 3.0 mm puncture knife in patients with stage I intraocular lens implantation. One foldable intraocular lens was implanted into the capsule to observe the improvement of postoperative visual acuity and the early and long-term complications during and after operation. The patients were followed up for 1 to 24 months. Results the operation was successfully completed in 57 eyes. There was no corneal incision leakage, the anterior chamber disappeared and the posterior capsule ruptured, and 1 eye appeared bubble in the anterior chamber during gas-liquid exchange. Intraocular lens implantation and silicone oil filling in 10 eyes, intraocular lens implantation but not silicone oil filling in 15 eyes, silicone oil filling but no intraocular lens implantation in 32 eyes. The postoperative visual acuity was improved in 51 eyes (89.5%), the visual acuity remained unchanged in 6 eyes (10.5%), and the intraocular pressure (IOP) was transient in 2 eyes (3.5%). At the last follow-up, the incision was closed well, the anterior chamber was deep, the lens was absent or intraocular lens was in place, and no intraocular lens clamping and displacement occurred. Conclusion in the combined anterior and posterior segment surgery, 1.8mm coaxial microincision phacoemulsification cataract surgery does not need suture, the anterior chamber is stable, the operation is safe, and has high application value. With the development of intraocular lens (IOL) and the improvement of economic level, microincision phacoemulsification is worth popularizing in clinic.
【作者单位】：郑州大学第二附属医院眼科;
【基金】：郑州市科技局基金资助(编号:121PCXTD523)~~
【分类号】：R779.6

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