人工晶状体眼后发性白内障的手术

目的探讨巩膜隧道切口插管灌注经睫状体平坦部后囊切开术治疗人工晶状体眼后发性白内障的效果。方法32例(34眼)人工晶状体植入术后后发性白内障行巩膜隧道切口插管灌注经睫状体平坦部后囊切开术。平均随访18个月。结果全部术眼晶状体后囊中央均形成直径3.5~4mm的圆形透明区,后发性白内障切开术的成功率为100%;术中前房稳定,人工晶状体无损伤。术后能配合视力检查的患者最佳矫正视力均恢复至后发性白内障发生前的最佳水平;随访期间无切口渗漏、角膜水肿、瞳孔区玻璃体疝、人工晶状体损伤、视网膜脱离、高眼压或晶状体后囊膜切开区再次浑浊等并发症。结论巩膜隧道切口插管灌注经睫状体平坦部后囊切除术治疗人工晶状体植入术后的后发性白内障安全、有效。

The surgical treatment for posterior capsule opacification on pseudophakic eyes

Objective To study the clinical value of pars plana capsulotomy and vitrectomy with infusion through the scleral tunnel incision to remove the posterior capsule opacification (PCO) on pseudophakic eyes. Methods This technique was perfomed in 32 casas (34 eyes) of complicated PCO with pseudophakic eyes,which was almost impossible to remove through the Nd:YAG capsulotomy. Pre-and post-operative visual acuity, intraocular pressure, complications during and after the operation were observed.The mean follow up time was 18 months. Results The central opaque posterior capsule and anterior vitreous were successfully removed in all patients without complication. A round hole with 3.5-4 mm diameter was obtained at the central part of the posterior capsule. In all 34 eyes, a clear visual axis was obtained. The visual acuity in all patients was improved and achieved the best level in their history. Visual acuity was 0.66 0.36,The best corrected postoperative visual acuity was 0.5 or better in 26 eyes (76.5%).1.0 or better in 10eyes (29.4%). There were no complications during the postoperative follow-up period, such as dislocation or damage of the IOL,corneal,vitreous prolapse, retina detachment and reocclusion of the visual axis. Conclusions Pars plana capsulotomy and vitrectomy with infusion through the scleral tunnel incision is a safe and effective procedure to remove the PCO in pseudophakic eye, especially for the cases with dense and thick opaque capsule formed after IOL implantation, which cannot be removed through the Nd:YAG capsulotomy.