前房型人工晶体在白内障术中后囊破裂的应用

从1994年以来,我院对现代白内障手术中后囊破裂大者,采用前房型人工晶体植入(下简称前房型)20眼,效果良好。并随机与后房型人工晶体巩膜缝线固定(下简称后房型缝线固定)20眼对照。现报告如下:资料与方法在后囊破裂大者40眼中,分别植入前房型及后房型缝线固定各20眼。其中前房型组:男12眼,女8眼;后房型缝线固定组:男9眼,女11眼。两组在年龄、性别及眼别上均随机,年龄43～81岁,平均62岁。人工晶体的选择:均为美国进口。前房型为新型S型弹性开放襻、一体式PMMA人工晶体;后房型为大C型襻一体式PMMA人工晶体。方法:手术由同一医生操作。常规…     

伴后囊破裂无晶状体眼后房型人工晶状体植入临床观察

我科1997年10月至2000年12月对32例伴后囊破裂无晶状体眼施行后房型人工晶状体植入术,疗效满意,报告如下。1资料与方法1.1 一般资料 伴后囊破裂无晶状体眼32例32眼,白内障超声乳化术后3例,白内障囊外摘出术后8例,外伤性白内障术后21例,其中伴有点状角膜白斑12例,伴片状角膜白斑9例且伴有局限前粘连3例。所有病例均有玻璃体外溢及不同程度虹膜后粘连。     

白内障术中后囊破裂的Ⅰ期后房型人工晶状体植入术

目的评价白内障囊外摘出术中后囊破裂行前段玻璃体切割联合Ⅰ期后房型人工晶状体植入的手术效果。方法对１４８０例白内障囊外摘出联合后房型人工晶状体植入术中４９例后囊破裂,行前段玻璃体切割联合Ⅰ期后房型人工晶状体植入的手术技巧、术后并发症和术后视力等进行分析。结果手术后囊破裂率为３．３％,７０％患者人工晶状体植入囊袋内,３０％患者为睫状沟,８９．９％患者出院时裸眼视力≥０．５。结论白内障囊外摘出术中后囊破裂,行前段玻璃体切割联合Ⅰ期后房型人工晶状体植入是安全有效的。     

白内障摘出术中后囊破裂时的I期人工晶状体植入

目的 评价在白内障摘出手术中后囊破裂时利和前囊I期后房人工晶状体樾主式的疗效。方法 对10例后囊破裂者利用计划性保留的前囊做为后支撑I期人工晶状体睫状沟植入。结果 术后随访3月,进行视力统计分析。裸眼视力：1.02例、0.84例、0.44例;矫正视力：1.04例、0.84、0.62例。结论 对位于中、下部后囊破裂及少量玻璃体脱出的病人,适当利用保留的前囊做为后支撑,仍可I期植入后房人工晶状体。     

白内障术中后囊破裂一期人工晶状体植入术

目的探讨白内障囊外摘出人工晶状体植入术中后囊破裂时一期人工晶状体植入的方法。方法对本院2004年1月。2005年6月行现代白内障囊外摘出人工晶状体植入术中因各种原因导致后囊破裂行一期人工晶状体植入的23眼进行回顾性分析。结果术后视力0．3以下者2眼，0．4～0．7者18眼，0．8～1．0者3眼。术后早期眼部反应较正常。结论术中因各种原因导致后囊破裂，只要处理好玻璃体和人工晶状体植入，就能取得术后较好的视力。     

后囊破裂的外伤性白内障人工晶状体植入术

自1993年5月～2001年5月,对后囊膜破裂的外伤性白内障35眼进行手术摘出并植入人工晶状体,取得较好效果,现报告如下.     

残留后囊或前囊为支撑人工晶状体Ⅰ期植入术

目的 观察颞侧透明角膜切口的晶状体超声乳化手术中后囊破裂时，以残留的后囊或前囊为支撑进行Ⅰ期折叠式人工晶状体植入术的成功率。方法 在28例(28眼)透明角膜切口超声乳化手术中各种原因导致的后囊部分破裂情况下，以残留的后囊或前囊作支撑，进行折叠式人工晶状体Ⅰ期植入术。结果 随访3～22月，人工晶状体位置稳定，未发现1例人工晶状体脱位，视力恢复满意。结论 在较好的环形撕囊前提下，后囊破裂者不必改变术式，仍可Ⅰ期植入折叠式人工晶状体，操作简单，效果良好。     

弹性开放襻前房型人工晶状体植入术临床观察

目的 观察弹性开放襻前房型人工晶状体植入术的疗效。方法 对32例32只眼白内障术中Ⅰ期或Ⅱ期植入弹性开放襻前房人工晶状体。结果 术后矫正视力＞0.3者29只眼,经长期随访未发现远期并发症。结论 前房型人工晶状体植入操作简便,安全可靠,术后效果好。     

Epilenticular intraocular lens implantation in traumatic cataract with a ruptured posterior capsule

PURPOSE: To present a case of rapidly progressing traumatic cataract caused by posterior capsule rupture after nonpenetrating ocular injury, as well as a surgical procedure to safely implant the intraocular lens in such a traumatized eye. METHODS: In a 23-year-old man with traumatic cataract and posterior lens capsule rupture, a one-piece polymethylmethacrylate IOL was implanted before cataract extraction into the ciliary sulcus in front of the cataractous lens. Subsequently, the cataract was removed by pars plana lensectomy. RESULTS: The surgery and postoperative course were uneventful. Postoperative visual acuity was 20/20. CONCLUSION: We present a method of intraocular lens implantation in cases of rapidly progressing traumatic cataract caused by posterior capsule rupture after a blunt ocular trauma.     

白内障手术中后囊硬性斑的处理

目的：探讨白内障患者后囊“硬性斑”的诊断及处理方法。方法：根据术前裂隙灯检查和手术中证实硬性斑的不同情况，选择后囊处理方式；首选“oerHi”环形撕囊仪环形撕囊，次之选用刺开撕囊，特殊的硬性斑用不同的环形切囊法。结果：oerHi环形撕囊仪5眼无1眼出现玻璃体溢出晶状体囊袋内，而刺开撕囊2眼有1眼玻璃体溢出晶状体囊袋内、环形切囊2眼均出现玻璃体溢出晶状体囊袋内，给予前段玻璃体切除，本组9眼人工晶状体均植入晶状体囊袋内。结论：用oerHi环形撕囊仪环形撕后囊“硬性斑”，安全、简便。刺开撕囊时，勿伤及玻璃体前膜，深度掌握有难度，环形撕囊时需做前段玻璃体切除准备。     

后囊大破裂口后房人工晶状体植入术临床观察

目的 探讨白内障手术中后囊大破裂口下植入后房人工晶状体的临床疗效.方法 26例(26眼)小切口非超声乳化白内障手术因失误导致后囊破裂,且破裂口大于1/2,经行脱出玻璃体切除处理后,充分利用残存囊行人工晶状体睫状沟植入,并回顾分析其疗效.结果 术后1周约80％达到0.3或以上矫正视力;主要并发症为角膜水肿浑浊(88.46％),但多在1周内消失.结论 本手术术后并发症少而轻,视力恢复较快,是白内障手术后囊大破裂口发生后仍能常规植入后房IOL的有效补救手段.     

Visual outcome following posterior capsule rupture during cataract surgery

AIM: To determine the relative risk of a poor visual outcome following posterior capsule rupture during cataract surgery. METHODS: Prospective data were collected on consecutive eyes undergoing cataract extraction. The patient's age, preoperative visual acuity, ocular comorbidity, grade of surgeon, and operative complications were documented. The best spectacle corrected visual acuity was recorded at discharge from the hospital service. RESULTS: From a total of 1533 cases, 1420 (92.6%) eyes had complete follow up data. Posterior capsule rupture occurred in 59 (4.1%) cases. Eyes with posterior capsule rupture were 3.8 times more likely to have a final best spectacle corrected visual acuity less than 6/12. CONCLUSIONS: Eyes having posterior capsule rupture during cataract surgery have a significant risk of reduced visual acuity.     

超声乳化术中后囊破裂时后房型人工晶体前囊夹持固定术

目的：评价超声乳化术中后囊不完整时的人工晶体前囊夹持固定术的效果。方法：对在超声乳化白内障摘除术中后囊破裂的64眼行后房型人工晶体前囊夹持固定术。结果：64眼均获得满意的人工晶体前囊夹持固定,没有一例发生人工晶体从前囊环上脱落。随访1－54个月,62眼恢复到0．5以上的视力,1．0以上者40眼。未发现其他与固定有关的并发症。结果：完整的前囊环行切开口是后囊不完整时夹持固定后房型人工晶体的最佳位置之一。     

Minimizing risk to the capsule during surgery for posterior polar cataract

Posterior polar cataract is associated with a deficiency of the posterior capsule in a high percentage of cases, leading to a high incidence of capsule rupture and potential vitreous loss. We describe an approach that minimizes the risk of vitreous loss. The key is viscodissection, a technique that can be applicable in other situations.     

Management of a posterior capsule rupture in planned extracapsular cataract extraction and posterior chamber lens implantation

Management of zonular dialysis and posterior capsule rupture during extracapsular cataract extraction is described. The Heslin gravity cannula is advocated to maintain the normal structure of the anterior segment in a closed chamber technique. Lens cortical material is stripped away using the manual technique described by Gills and McIntyre to avoid vitreous loss. It is then possible to proceed with posterior chamber lens implantation. If vitreous loss occurs, an adequate anterior vitrectomy with an automated vitreous cutter is recommended. A posterior chamber lens implant is preferred if there is adequate capsule to support the lens.