超声乳化术治疗玻璃体切割术后并发性白内障的疗效观察

Clinical study of phacoemulsification with complicated cataract after vitrectomy surgery

摘要:

目的：探讨超声乳化术治疗玻璃体切割术后并发性白内障的手术特点、安全性及临床疗效。

方法：对39例39眼玻璃体切割术后并发性白内障的患者行超声乳化术，其中对有硅油充填的23眼联合硅油取出术，观察手术前后视力及术中、术后并发症。术后随访3～24(平均10)mo。

结果：所有病例术中无严重并发症发生。术后最佳矫正视力37眼(95%)提高，2眼(5%)无改变，无视力下降者。1眼硅油取出后2wk视网膜脱离复发，1眼术后1mo玻璃体出血，均行玻璃体切割联合硅油填充术而治愈。无脉络膜出血、低眼压等并发症。

结论：玻璃体切割术后并发性白内障眼内情况复杂，手术难度大，超声乳化术是一种安全有效的手术方法。

Abstract:

AIM: To evaluate the characteristics, safety and effectiveness of phacoemulsification with complicated cataract after vitrectomy surgery.

METHODS:Thirty-nine patients(39 eyes)with complicated cataract after vitrectomy were operated by phacoemulsification, among which 23 eyes after silicon oil tamponade were combined with silicon oil removal. Preoperative and postoperative best corrected visual acuity(BCVA)and complications were recorded. The mean follow-up period was 10 months, with the range from 3 to 24 months.

RESULTS:There were no serious surgical complications. Postoperatively, BCVA improved in 37 eyes(95%), and did not change in 2 eyes(5%). No decreased visual acuity was observed on the patients. One case had recurrent retinal detachment at two weeks after silicon oil removal, and one case had vitreous hemorrhage at one month. Both eyes were treated with vitrectomy and silicon oil tamponade and were cured. Postoperative complications, such as choroidal hemorrhage, ocular hypotension and so on were not observed.

CONCLUSION: Cataract is complicated and surgery can be much more challenging after vitrectomy. Phacoemulsification is safe and effective for complicated cataract in vitrectomized eyes.