白内障术后角膜后弹力层脱离（DMD）临床诊治分析（附1例病例报告）

发布时间：2018-04-25 09:19

本文选题：白内障 + 角膜浑浊　；参考：《浙江大学》2011年硕士论文

【摘要】：[目的] 通过病例回顾,分析白内障超声乳化联合人工晶体植入术后角膜后弹力层脱离的临床表现、诊断和治疗方法,探讨其发病机制、诊断标准和治疗思路,从而为术中及术后角膜后弹力层的预防、早期诊断和合理治疗提供依据。 [方法] 统计2010年6月至2011年3月期间于浙江大学医学院附属第二医院眼科中心住院病人中诊断为角膜后弹力层脱离的1例病人的临床资料,并运用裂隙灯显微镜、超声生物显微镜(UBM)和眼前段照相进行临床观察研究。运用美国国立医学图书馆Pubmed数据库,输入关键词(白内障、角膜、后弹力层脱离)检索1980-2010年间在线文献数据,全面剖析白内障超声乳化联合人工晶体植入术后并发角膜后弹力层脱离的发病机制、临床表现、诊断和治疗方法。 [结果] 2010年6月至2011年3月期间本院住院患者中诊断为角膜后弹力层脱离的患者共1例(1只眼)。女性,70岁,左眼因老年性白内障于我院行白内障超声乳化联合人工晶体植入术。术中即发现角膜后弹力层局限性脱离,于术中注射粘弹剂复位。一月后,后弹力层复位失败,行角膜全层缝合术复位,3月后拆线。复位成功,角膜恢复透明状态。 [结论] 1.角膜后弹力层脱离是一种会造成严重视力缺损的并发症。 2.早期诊断对保留视力,预防角膜后弹力层永久损伤有积极的作用。 3.小范围的脱离无须手术复位,大范围的或者进行性的脱离则需要手术介入。 4.诊断明确成功复位对患者的视力恢复有着至关重要的作用。
[Abstract]:[purpose] The clinical manifestations, diagnosis and treatment of posterior elastic layer detachment after phacoemulsification combined with intraocular lens implantation were analyzed, and the pathogenesis, diagnostic criteria and treatment ideas were discussed. It provides basis for prevention, early diagnosis and reasonable treatment of posterior elastic layer of cornea during and after operation. [methods] From June 2010 to March 2011, the clinical data of one patient diagnosed as posterior elastic layer detachment of cornea in the eye center of the second affiliated Hospital of Zhejiang University Medical College were analyzed, and slit lamp microscope was used. Ultrasound biomicroscopy (UBM) and anterior segment photography were used for clinical observation. The National Library of Medicine (Pubmed) database was used to search online literature data from 1980 to 2010 by inputting key words (cataract, cornea, posterior elastic layer detachment). To analyze the pathogenesis, clinical manifestation, diagnosis and treatment of posterior elastic layer detachment after phacoemulsification combined with intraocular lens implantation. [results] From June 2010 to March 2011, one patient was diagnosed as posterior elastic layer detachment of cornea. A 70-year-old female with cataract phacoemulsification combined with intraocular lens implantation was performed in our hospital for senile cataract. Local detachment of the posterior elastic layer of cornea was found during the operation. After one month, the posterior elastic layer failed to be restored, the whole corneal suture was restored, and the thread was removed after 3 months. The reposition was successful and the cornea returned to a transparent state. [conclusion] 1. Posterior elastic layer detachment is a complication that can cause severe visual impairment. 2. Early diagnosis plays a positive role in preserving visual acuity and preventing permanent injury of the posterior elastic layer of cornea. 3. Small disengagement requires no surgical reduction, and large or progressive disengagement requires surgical intervention. 4. Diagnosis and successful reduction are very important to the recovery of visual acuity.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R779.6

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