Phacoemulsification combined with transpupillary removal of silicone oil and intracapsular intraocular lens implantation

AIM: To estimate the effectiveness of phacoemulsification and foldable intraocular lens (IOL) implantation combined with transpupillary silicone oil removal. METHODS: There were 168 eyes of 168 candidate patients with cataract and silicone oil-filled eyes recruited in our study. All of the patients received the intraocular silicone oil removal surgery by transpupillary drainage and cataract extraction by phacoemulsi?cation. Then the IOL implantation were also performed through corneal incision. RESULTS: The surgery was successfully completed in all eyes. Best corrected visual acuity (BCVA) and postoperative complications were recorded in three months after surgery. There were 143 eyes with BCVA improved, otherwise 25 eyes remained stable at the last follow-up visit. The mean BCVA statistically improved from 20/400±0.02 to 20/100±0.15 (P<0.001) and mean postoperative IOP was 13.85±2.18 mm Hg (P=0.415). No intra-operative complications were reported. CONCLUSION: Phacoemulsi?cation combined with transpupillary removal of silicone oil is a safe and simple effective method. In general, it enables quick recovery of visual acuity with less complication rate.     

透明角膜切口的白内障超声乳化摘除及折叠式人工晶体植入术

目的评价通过透明角膜切口的白内障超声乳化摘除及折叠式人工晶体植入手术的疗效。方法采用上方３．２ｍｍ梯形透明角膜切口,对９０例（１００只眼）老年性、并发性、先天性和外伤性白内障行超声乳化摘除,并植入硅胶或ＨＥＭＡ折叠式人工晶体。结果术后１天裸眼或球镜矫正视力≥０．５者占９３．０％;术后１周,１个月和３个月视力≥１．０者分别占５６．０％,６５．１％和６７．５％。术后１周平均散光为０．９３±０．５８Ｄ,比术前增加０．２０Ｄ（Ｐ＜０．００１）。术后１个月和３个月平均散光分别为０．７８±０．６０Ｄ和０．７３±０．５９Ｄ,与术前无统计学差异（Ｐ＞０．０５）。结论提示透明角膜切口的超声乳化和折叠式人工晶体植入术具有早期恢复和稳定眼屈光状态和视力的优点。     

颞侧透明角膜隧道切口的超声乳化白内障吸出及折叠式人工晶体植入术

目的探讨经颞侧透明角膜隧道切口的超声乳化白内障吸出及折叠式人工晶体植入术的效果及其优、缺点。方法用钻石刀在颞侧角膜周边血管弓中央的透明角膜上，做一深０．３０ｍｍ、宽１．７５ｍｍ和内口长３．２０ｍｍ、外口长３．５０ｍｍ的梯形角膜隧道切口，对８１２例（８４５只眼）老年性白内障施行超声乳化白内障吸出及折叠式人工晶体植入术，术后观察视力、角膜地形图、角膜散光及角膜内皮的变化。结果术后第１天和１个月，６１．３０％和７９．０５％的术眼裸眼视力达到或超过０．５，术后早期切口附近角膜变平，视轴中央角膜散光有轻微变化，角膜内皮细胞丢失率为８．２３％。并发症主要有切口热灼伤（０．４０％）、术中后囊膜破裂（１．０７％）、晶体脱位（０．１２％）、眼内炎（０．１２％）和囊样黄斑水肿（０．２４％）。结论经颞侧透明角膜隧道切口施行超声乳化白内障吸出及折叠式人工晶体植入术，操作便利，手术疗效良好、稳定     

颞侧透明角膜隧道切口的超声乳化白内障吸出及折叠式人工晶体植 …

目的 探讨经颞侧透明角膜隧道切口的超声乳化白内障吸出及折叠式人工晶体植入术的效果及其优,缺点。方法 用钻石刀在颞侧角膜周边血管弓中央的透明角膜上,做一深０．３０ｍｍ,宽１．７５ｍｍ和内口长３．２０ｍｍ,外口长３．５０ｍｍ的梯形角膜隧道切口,对８１２例（８４５只眼）老年性白内障施行超声乳化白内障吸出及折叠式人工晶体植入术,术后观察视力,角膜地形图,角膜散光及角膜内皮的变化。结果 术后第１天和１个月,     

表面麻醉颞侧位超声乳化及人工晶状体植入术

目的:探讨并总结表面麻醉颞侧位超声乳化技术及5.5mm无缝线遂道切口人工晶状体植入术的方法和经验。方法:总计植入5.5mmPMMA人工晶状体采用无缝线隧道切口的白内障患者529例(568眼),植入折叠式人工晶状体患者51例(51眼)。前者核硬度为I和II级者248眼,III级296眼,IV级24眼。后者核硬者为I和II级者30眼,III级21眼,颞侧位超声乳化碎核,能量设定为50%~70%,有效超声时间10~88(平均46)s。结果:术后第1d视力≥0.5者分别为75%和76%,术后1mo裸眼或矫正视力≥0.5者分别为87%和84%,平均散光分别为0.25±0.38D和0.58±0.62D,两组比较,差异无显著性(P>0.05)。全部病例均无需缝线,96%的表麻颞侧位超声乳化成功,手术主要并发症是后囊破裂和虹膜色素脱失。结论:表麻颞侧位超声乳化白内障吸除术及5.5mm无缝线隧道切口的人工晶状体植入术与折叠术人工晶状体一样,具有手术时间短,无需缝线,视力恢复快等优点,而价格相对便宜,特别是对不宜在原位手术的患者是一种安全有效的手术方式,故值得推广。     

白内障超声乳化摘除及无缝线切口人工晶体植入术

评价白内障超声乳化摘除合并无缝线切口人工晶体植入术的疗效。对１０２只眼白内障进行超声乳化摘除术，并通过５．５ｍｍ无缝线切口植入后房型人工晶体。术后随访２周－２个月，术后裸眼视力≥０．３者占９５．１０％；术中及术后无任何严重并发症。该手术具有切口小、安全、可靠早期视力恢复好等优点。本文详细介绍了手术过程，并对手术技巧进行了探讨。     

巩角膜隧道切口白内障超声乳化吸附及人工晶状体植入术

目的　探讨巩角膜隧道切口的白内障超声乳化吸除及硬性 PMMA人工晶状体植入术的疗效。方法　在上方角膜缘后界做 3.5 m m隧道切口 ,对 6 8例 (72眼 )老年性、并发性和外伤性白内障行超声乳化术 ,并植入硬性 PMMA人工晶状体。结果　术后 1天、1周、1个月和 3个月裸眼视力≥ 0 .5者分别为 84.4%、88.8%、91.7%和93.1%。术后 1周平均散光为 (1.2 5± 0 .2 5 D)。比术前增加 0 .10 D(P >0 .0 5 )。术后 1个月和 3个月平均散光分别为 (0 .90± 0 .2 5 D)和 (0 .75± 0 .5 0 D) ,与术前无统计学差异 (P >0 .0 5 ) ,与巩膜隧道切口散光比较结果基本相同。结论　经巩角膜隧道切口白内障超声乳化吸除及硬性 PMMA人工晶状体植入 ,操作便捷 ,手术疗效好 ,视力及屈光状态稳定。     

超声乳化白内障摘出及5.5mm切口晶状体植入术

目的探讨并总结原位超声乳化技术及５．５ｍｍ无缝线隧道切口人工晶状体植入术的方法和经验。方法总计５．５ｍｍ无缝线隧道切口的白内障４６８只眼,刻度钻石刀作巩膜隧道切口,原位超声乳化,能量为５０％～７０％,时间１０ｓ至１ｍｉｎ３８ｓ,平均４６ｓ,植入５．５ｍｍＰＭＭＡ人工晶状体。结果术后第１天视力≥０．５者９５％,术后１个月视力≥１．０者９６％,全部病例无严重并发症。结论原位超声乳化白内障摘出及５．５ｍｍ无缝线隧道切口的人工晶状体植入术,具有手术时间短、无缝线、散光小及视力恢复快等优点。     

角巩缘隧道切口的白内障超声乳化摘除及折叠式人工晶体植入术

评价经角巩膜隧道切口的白内障超声乳化摘除及折叠式人工晶体植入手术的方法和疗效。方法在上方角巩缘做３．２ｍｍ梯形隧道切口,地１０３例老年性、并发性、先天性和外伤性白内障超声乳化摘除,并植入ＨＥＭＡ折叠式人工晶体。     

门诊白内障患者表面麻醉下行超声乳化摘出术

目的 分析和探讨表面麻醉下行人障超声乳化摘出及人工昌状体植入术的可行性及其效果。方法 门诊非选择性地对１３２例１５７眼各种类型白内障在表面麻醉下进行了超声乳化摘出并人工晶状体植入术。结果 １５２眼（９６．８％）。麻醉满意,５眼（３．２％）增加球后麻醉后完成手术,术后视力及并发症与本科以往球后麻醉下所行白内障超声乳化术的效果相似。结论 表面麻醉下做巩膜隧道切口可满意地完成白内障超声乳化摘出及人工晶状体植入术,为门诊开展本手术提供了便利。     

Phacoemulsification combined with silicone oil removal through a posterior capsulorhexis

PURPOSE: To evaluate the technique of silicone oil removal through a posterior capsulorhexis combined with phacoemulsification and intraocular lens (IOL) implantation. SETTING: Dr. Rajendra Prasad Center for Ophthalmic Sciences, New Delhi, India. METHODS: Fifteen eyes of 15 patients had phacoemulsification with removal of silicone oil, which had been used for intraocular tamponade after a previous pars plana vitrectomy. Eyes with a stable retina were included in the series. In all eyes, the silicone oil was removed through a planned posterior capsulorhexis after phacoemulsification. The parameters evaluated were the primary diagnosis, duration between silicone oil instillation and phacoemulsification, type of cataract, preoperative and postoperative best corrected visual acuities (BCVAs), and complications such as frequency of retinal redetachment and secondary cataract. RESULTS: Vitreoretinal surgery with silicone oil instillation was performed for rhegmatogenous-tractional detachment resulting from Eales' disease in 6 eyes and from proliferative diabetic retinopathy in 2 eyes, for primary rhegmatogenous retinal detachment in 6 eyes, and for traumatic rhegmatogenous detachment in 1 eye. The mean duration between the silicone oil instillation and phacoemulsification was 7.5 months +/- 3.8 (SD). Fourteen eyes had posterior subcapsular cataract, and 10 had nuclear sclerosis. Preoperative BCVA was worse than 6/60 in all eyes. The BCVA was 6/60 or better in 9 eyes after a minimum follow-up of 6 months. Two eyes had choroidal detachment in the early postoperative period. No eye had vitreous hemorrhage, retinal redetachment, secondary cataract, clinically significant endothelial decompensation or macular edema, or a dislocated IOL. CONCLUSION: The results indicate that silicone oil removal through a posterior capsulorhexis during phacoemulsification is a viable option and can be performed in selected cases of cataract with previous silicone oil instillation and a stable retina.     

抗青光眼滤过术后超声乳化白内障吸除术的临床观察

目的　探讨抗青光眼滤过手术后进行白内障手术的方法及手术对滤过泡的影响。方法对抗青光眼小梁切除术后白内障患者 2 35例 (2 6 2只眼 ) ,采用颞侧透明角膜隧道切口进行超声乳化白内障吸除及折叠式人工晶状体植入手术 ,同时对固定的小瞳孔进行扩张或采用括约肌切开与缝合术。结果　白内障术后患者视力不同程度提高 ,视力≥ 0 5者占 74 0 % ;术后平均眼压升高 3 0 8mmHg(1mmHg =0 133kPa) ,与术前比较差异无显著性 (P >0 0 5 ) ;功能性滤过泡未见明显瘢痕化。结论　对抗青光眼滤过术后白内障患者进行颞侧透明角膜隧道切口超声乳化白内障吸除术 ,可提高视力 ,同时可保持滤过泡功能。     

Topical anesthesia for transpupillary silicone oil removal combined with cataract surgery

PURPOSE: To assess safety of topical anesthesia for transpupillary silicone oil removal in combination with cataract surgery. SETTING: Department of Ophthalmology Mannheim, University of Heidelberg, Mannheim, Germany. METHODS: The clinical interventional study included 37 consecutive patients having transpupillary silicone oil removal combined with cataract surgery. Without exception, surgery was carried out in topical anesthesia for all patients. During the study period, there were no patients having transpupillary silicone oil removal in another type of local anesthesia than topical anesthesia. Topical anesthesia was achieved with oxybuprocaine 0.4% eyedrops installed 4 to 5 times prior to surgery. Cataract surgery was performed using the clear cornea technique with implantation of a foldable intraocular posterior chamber lens. Silicone oil was released through a planned posterior capsulotomy during cataract surgery prior to implantation of the intraocular lens (IOL). RESULTS: For all patients, surgery could be carried out in topical anesthesia without switching to peribulbar or any other type of anesthesia. None of the patients complained about severe pain intraoperatively or postoperatively. No severe complications such as expulsive hemorrhage, luxation of the IOL, or iris incarceration were encountered in any of the surgeries. CONCLUSION: Transpupillary silicone oil through a planned posterior capsulotomy during cataract surgery may be performed in topical surgery.     

硅油填充并发白内障行超声乳化联合硅油取出及人工晶状体植入术观察

目的 评价硅油填充合并白内障眼经透明角膜切口行白内障超声乳化,联合经瞳孔硅油取出及折叠人工晶状体植入的临床效果.方法 选择硅油填充术后合并白内障患者27只眼,手术方法为经透明角膜切口行白内障超声乳化,然后做3 mm大小的晶状体后囊切开,通过前房灌注,由后囊切开处进行硅油取出,将折叠晶状体植入囊袋内或者睫状沟.评价手术时间、术后反应以及视力恢复效果.结果 手术时间基本控制在20分钟以内,大部分病例折叠人工晶状体植入囊袋内.术后未见视网膜脱离复发、IOL脱位和其他严重并发症,部分病例有不同程度的角膜水肿,患者无明显刺激症状.结论 经透明角膜切口行白内障超声乳化联合经瞳孔区硅油取出并植入折叠人工晶状体,这种方法与经巩膜切口的方法相比,不但减少了手术的时间,而且从理论上也较少了术后并发症和患者的刺激症状,是一种安全高效的硅油取出联合白内障手术方式.     

青光眼术后颞侧透明角膜切口白内障超声乳化术

目的 探讨抗青光眼滤过术后进行白内障手术的方法和疗效评价。方法 对２６例（２７眼）小梁切除术后白内障患者，采用颞侧透明角膜切口白内障超声乳化摘出及人工晶状体植入术，术后随访半年。结果２７眼中２４限术后视力不同程度提高（８８．８９％），眼压（１３．１８±３．７２）ｍｍＨｇ。结论 对抗青光眼滤过术后白内障患者采用颞侧透明角膜切口白内障超声乳化摘出及人工晶状体植入术，可提高视力并保持滤过泡的功能。     

硅油取出联合白内障摘除并人工晶状体植入术的临床分析

目的：对硅油填充术后白内障手术结果进行总结分析。方法：行白内障囊外除联合人工晶状体植人及取出硅油。结果：经4～24mo随访,22例(22眼),视力2眼(9％)光感～指数;12眼(54％)≥0．1;6眼(27％)达到≥0．3;1眼(5％)最佳矫正视力达1．0;其中1眼(5％)出现视网膜脱离复发,经再次硅油充填后视网膜复位。结论：硅油填充术后的白内障囊外除联合人工晶状体植入术与同时取出硅油是一种较理想的方法。