白内障超声乳化吸除联合人工晶状体植入术后缺血性视神经病变临床分析

目的探讨白内障超声乳化吸除联合人工晶状体植入术后并发缺血性视神经病变(ION)的病因及治疗效果。方法回顾性分析7例(7只眼)我院行白内障超声乳化吸除联合人工晶状体植入术后ION的临床资料,7例患者分别行眼底、相干光断层扫描(OCT)、视野、荧光素眼底血管造影(FFA)等检查,予以激素、扩管、营养神经及对症治疗。结果治疗2周后7例视力均有不同程度提高,视盘水肿减轻或消失,出血部分吸收或完全吸收,5例视野得到改善,无1例发生视神经萎缩。结论白内障术后眼压与睫状后动脉以及筛前毛细血管灌注压平衡破坏可导致ION,表现为突然视力障碍,眼底出现视神经乳头水肿乃至视神经萎缩。术后及早发现、尽早使用激素、血管扩张剂等治疗,可有效控制疾病的发展并促进恢复。

Clinical analysis of ischemic optic neuropathy following phacoemulsification with intraocular lens implantion

Objective To analyze the causes and evaluate the therapeutic effects of ischemie optic neuropathy fol- lowing Phacoemulsifieation with IOL. Methods Retrospective analysis the diagnoses and treatments of 7 cases of postoperative ischemic optic neuropathy following Phaceemulsilication with intraecular lens implantion. Results With 2 weeks combination therapy of systematic corticosteroids, compound Anisodine injection and orally methazolamide tables, the whole 7 cases made an improvement on vision, papilloedema. 5 cases got better in vision filed. None of them developed into optic nerve atrophy. Conclusion The etiology could be the fluctuation of IOP, low perfusion of ocular vessels. Early diagnosis and treatment could prevent the bad prognosis