玻璃体切割联合眼后段超声粉碎治疗溶解性晶体全脱位

目的评价通过闭合式切口的玻璃体切割和眼后段超声粉碎治疗溶解性晶体全脱位的疗效。方法对１例２眼的马凡氏综合征（Ｍａｒｆａｎ＇ｓｓｙｎｄｒｏｍｅ）溶解性晶体全脱位继发青光眼先后行闭合式玻璃体切割，并采用后段超声粉碎技术辅以导光纤维为第二器械帮助，直至把核粉碎完毕。结果２只全脱位晶体顺利超声粉碎吸除，辅以药物控制术后１月１．８８ｋＰａ（２５ｍｍＨｇ）和１．５３ｋＰａ（２１ｍｍＨｇ）；术后３月不用药物眼压分别为１．５１ｋＰａ（２０．３ｍｍＨｇ）和１．５２ｋＰａ（２０．７ｍｍＨｇ）；矫正视力为右眼：０．４，左眼：０．５。结论对于单纯性晶体全脱位、溶解性晶体全脱位和超声乳化时核脱入玻璃体腔者可采用此项闭合切口下玻璃体切割联合晶体后段超声粉碎技术

Treatment of phacolytic lens luxation with virectomy combined with posterior segmental phacofragmentation

Objective To evaluate the effect of treatment of phacolytic lens luxation with virectomy combined with posterior phacofragmentation.Method One patient of Marfan's syndrome who suffered from lens luxation and phacolytic glaucoma on both eyes were treated with closed-incision virectomy,and with with the help of light pipe as a second instrument,posterior segmental phacofragmentaion were performed to extract the dislocated lens.Result Both lens were extracted completely.One month later the intraocular pressure(IOP) decreased to 1.88kPa(OD)and 1.53kPa(OS) combined with drug therapy.Three month after the operation the IOP were 1.51kPa(OD) and 1.52kPa(OS) without drug administration,the visual acuity were 0.4(OD) and 0.5(OS).Conclusion The technique of closed-incision virectomy combined with posterior segmental phacofragmentation of lens can be performed under the condition of simple lens luxation,phacolytic lens luxation,and lens nucleus dropping into vitreous cavity during phacoemulsification.