超声乳化联合人工晶体植入术治疗晶状体半脱位的临床研究

目的探讨超声乳化联合人工晶体植入术治疗晶状体半脱位白内障的效果。方法对50例（54只眼）晶状体半脱位随机分两组。一组30例（34只眼）晶状体半脱位患者行超声乳化联合人工晶体植入术,其中4只眼联合前段玻璃体切除;一组20例（20只眼）晶状体半脱位患者行小切口晶体囊外摘除术联合人工晶体植入术,其中6只眼联合前段玻璃体切除。结果 54只眼术后视力均有不同程度提高,6只眼因术前视网膜挫伤,视力无改善,两组在术后视力及术后并发症上有显著性差异。结论采用超声乳化联合人工晶体植入术治疗晶状体半脱位患者,对减少了其他手术方法并发症的发生、提高患者的术后视力,有一定的疗效。     

白内障患者可调节人工晶体植入术围手术期的观察与护理

目的:探讨白内障患者可调节人工晶体植入术的围手术期护理.方法:回顾性分析2009年1月～2010年8月于我院行白内障超声乳化联合Tetraflex可调节人工晶状体植入术患者100例,加强术前评估及术后病情观察护理.结果:经过全面用到科学的护理,100例患者远、中、近视力均得到不同提高,并发症较少,基本不需要戴花镜,提高了生活质量,总体满意度好.结论:可调节人工晶状体患者对护理有更高的要求,细致的护理能有效提高患者的生活质量和满意度,及时发现并发症.     

穿通性眼外伤合并外伤性白内障Ⅰ期与Ⅱ期手术治疗效果分析

目的分析穿通性眼外伤合并外伤性白内障Ⅰ期与Ⅱ期手术的治疗效果。方法选取2015-03—2016-02间收治的60例(60眼)穿通性眼外伤合并外伤性白内障患者,随机分为2组,各30例。对照组采用Ⅰ期外伤性白内障摘除术和人工晶状体植入术,观察组采用Ⅱ期外伤性白内障摘除术和人工晶状体植入术,比较2组并发症发生率及远期效果。结果观察组并发症发生率明显低于对照组,差异有统计学意义(P0.05)。观察组与对照组相比,前房深度增加,角膜荧光评分较低,BUT评分较高,差异有统计学意义(P0.05)。结论与Ⅰ期手术相比,Ⅱ期外伤性白内障摘除术和人工晶状体植入术并发症较少、创伤小,安全性高、远期效果佳。     

高度近视白内障超声乳化人工晶体植入术临床观察

目的观察超声乳化联合人工晶体植入术治疗高度近视白内障的手术效果。方法回顾性分析53例(77眼)高度近视并发白内障手术病例。其中眼轴<30mm者46例,眼轴≥30mm者31眼。行表面麻醉下透明角膜切口超声乳化白内障摘除联合人工晶状体植入术,观察术前、术后最佳矫正视力、术中术后并发症情况。随诊时间5～12个月,平均8.3个月。结果本组病例眼轴26.67～35.57mm,术后75眼视力明显提高,术后3个月最佳矫正视力≥0.3者65眼,占84.42%,术后3个月最佳矫正视力≥0.5者47眼,占61.04%,不同眼轴长度组术后最佳矫正视力有明显差异。术后视力无提高者2眼,主要影响因素为高度近视黄斑病变。术中3眼发生后囊膜破裂,其中2例仍植入晶体于囊袋内,1例行人工晶体睫状沟植入。随访其术后并发症主要为后囊膜混浊。结论表面麻醉下透明角膜切口超声乳化人工晶状体植入术治疗高度近视并发白内障效果理想,最终视力决定于眼底情况,眼轴越长,视力预后越差。     

白内障超声乳化显微手术治疗葡萄膜炎继发青光眼合并白内障的疗效观察

分析超声乳化白内障摘除联合人工晶状体植入术治疗葡萄膜炎继发青光眼的降眼压效果及手术安全性.方法 对萄萄膜炎继发青光眼施行透明角膜切口超声乳化白内障摘除联合人工晶状体植入术15例(16眼),分析术前、术后情况.结果 术后视力较术前提高,术后随访矫正视力0.5以上者达50%,术后眼压及降压药物的种类均下降,并发症有术中前房出血3眼,术后不同程度的角膜水肿4眼.结论 葡萄膜炎继发青光眼患者行透明角膜切口白内障超声乳化吸除联合人工晶状体植入可获得理想的疗效.     

手法小切口白内障手术治疗糖尿病性白内障的疗效分析

目的分析手法小切口白内障摘除联合人工晶状体植入术治疗糖尿病性白内障的疗效。方法对68例（96眼）糖尿病合并白内障的患者行小切口白内障摘除及人工晶状体植入术的临床资料进行回顾性分析。统计术后1、30d的视力,术后视力与糖尿病病程的关系以及术后并发症。结果术后第1天裸眼视力〉0.5者69眼（71.88%）,0.3～0.5者18眼（18.75%）,0.1～0.25者6眼（6.25%）,〈0.1者3眼（3.13%）;术后第30天裸眼视力〉0.5者74眼（77.08）,0.3～0.5者16眼（16.67%）,0.1～0.25者4眼（4.17%）,〈0.1者2眼（2.08%）。术后并发症主要有角膜水肿、前房纤维素性渗出、虹膜粘连、继发青光眼。结论手法小切口白内障摘除联合人工晶状体植入术治疗糖尿病性白内障是安全有效的,术后视力的恢复与糖尿病病程及糖尿病视网膜病变有关。     

白内障超声乳化联合人工晶体植入治疗白内障临床疗效分析

目的探讨白内障超声乳化(Phaco)联合人工晶体植入术治疗白内障的临床疗效。方法选取2018年1月至2020年12月于本院接受治疗的92例白内障患者,依据双盲法分为观察组(46例)与对照组(46例)。对照组予以人工晶体植入术治疗,观察组在对照组基础上联合Phaco治疗。对比两组术前、术后24周视觉功能与生活质量变化情况。结果两组术前视觉功能评分比较,差异无统计学意义(P0.05),术后24周两组视觉功能评分均较术前上升,且观察组视觉功能评分高于对照组,差异均有统计学意义(P0.05);两组术前生活质量评分比较,差异无统计学意义(P0.05);术后24周两组生活质量评分均较术前上升,且观察组生活质量评分高于对照组,差异均有统计学意义(P0.05)。结论白内障患者采用Phaco联合人工晶体植入术治疗效果确切,可提升视觉功能与生活质量,值得临床推广。     

糖尿病性白内障小切口非超声乳化及人工晶状体植入术的临床分析

目的探讨糖尿病性白内障小切口非超声乳化及人工晶状体植入术的疗效。方法糖尿病组：共31例36眼,非糖尿病组：共43例54眼。糖尿病组空腹血糖控制在8.3 mmol/L以下,2组均施行白内障小切口非超声乳化及人工晶状体植入术,观察术后视力及术中、术后并发症。结果随访3～6月。术后1个月糖尿病组矫正视力≥0.6者30眼（83.33%）,非糖尿病组为49眼（90.74%）,经统计学处理,x2值0.947,2组差异无统计学意义（P〉0.05）。结论糖尿病性白内障患者在术前空腹血糖控制良好的情况下行小切口非超声乳化吸除联合人工晶状体植入术能获得较满意疗效,是安全可靠的。     

复合式小梁切除术与超声乳化白内障吸除术分期手术临床探讨

目的 通过对复合式小梁切除术、超声乳化白内障吸除术与可折叠式人工晶状体植入术分期手术治疗的回顾性分析，探讨青光眼合并白内障的手术方式选择。方法 收集2000年至2002年期间行复合式小梁切除术，而后再行超声乳化白内障吸除术与可折叠式人工晶状体植入术54例58只眼，对2种手术前后的白内障，视力及眼压进行比较，并对2种手术间隔时间的相关因素进行分析。结果 复合式小梁切除术后品状体混浊程度加重、视力下降，经超声乳化白内障吸除术与可折叠式人工晶体植入术后视力基本回复。短期内白内障手术未影响小梁切除术后的眼压。抗青光眼手术与白内障手术间的间隔时间与患者年龄及青光眼术前眼压无相关性（P〉0．05）。原发性闭角型青光眼的手术间隔时间短于原发性开角型青比眼，差异有统计学意义（P〈0．05）。结论 对于原发性闭角型青光眼，存选择下术治疗方式时须考虑白内障的影响。对于低视力患者，当需要进行滤过性手术时，复合式小梁切除术与超声乳化白内障吸除术的联合治疗可能优于分期手术治疗。     

超声乳化术对高度近视合并白内障患者视觉质量的影响

目的以小切口手法碎核术对比分析超声乳化术对高度近视合并白内障患者视觉质量的影响,以探讨其临床应用价值。方法选取本院收治的高度近视合并白内障单眼病变患者72例,以随机数字表分为观察组和对照组各36例;对照组采用小切口手法碎核术和人工晶状体植入术进行治疗,观察组采用超声乳化术和人工晶状体植入术进行治疗。根据患者个体情况随访6-12个月,记录最佳矫正视力和并发症发生情况;并分别于治疗后1周、3个月及6个月常规检查术源性散光、屈光状态、中央角膜厚度（CCT）、角膜细胞计数（CEC）、角膜敏感度及黄斑中心凹视网膜厚度（CMT）。结果术前,两组患者的BCVA无统计学差异（P〉0.05）;术后,两组患者BCVA均有显著改善（P〈0.001）,且观察组明显优于对照组（P〈0.05）。术前,两组患者的各项角膜、黄斑区及相关光学指标无统计学差异（P〉0.05）;术后,观察组各时间段的术源性散光度和CMT显著小于对照组（P〈0.001）,角膜敏感度显著优于对照组（P〈0.001）。此外,观察组的角膜水肿发生率显著低于对照组（P〈0.05）,但总并发症发生率无统计学差异（P〉0.05）。结论超声乳化术相对封闭的操作环境能够维持前房稳定性,利于保护角膜神经,提高高度近视合并白内障患者的术后视觉质量。     

小瞳孔下切口白内障人工晶状体手术35例探索

目的：探讨小瞳孔下切口白内障人工晶状体手术的临床治疗效果。方法选取我院2011年12月～2013年12月接收的小瞳孔白内障患者35例,所有患者均采用小切口非超声乳化白内障摘出人工晶状体植入术进行治疗,观察治疗效果。结果术后30d,20例矫正视力≥0.5,13例为0.1～0.4,2例＜0.1;均伴有不同程度的葡萄膜炎反应（7～10d消退）,2例出现巩膜隧道切口外口暴露（切口无渗漏,未做特殊处理,7-10d被结膜覆盖）,3例中度角膜水肿（7d内恢复）,2例前房小量出血（不影响手术,术后2d内吸收）。结论小瞳孔白内障患者行小切口非超声乳化白内障摘出人工晶状体植入术治疗效果满意,值得推广。     

Monocular traumatic cataract, extraocular muscle deviation, and intraocular lens implantation.

I report seven patients with monocular traumatic cataract who had either preinjury or postinjury extraocular muscle deviation. All but one were managed with cataract extraction and intraocular lens implantation, without muscle surgery. If muscle surgery is required in such cases, I recommend that it be delayed until at least a year after the cataract and lens implantation surgery.     

Keratoplasty and intraocular lenses: follow-up study.

In an effort of explore new approaches with the possibility of improving on existing methods of managing problem cases with combined corneal disease and cataracts, 35 patients were treated by keratoplasty, cataract extraction, and intraocular lens implantation in various combinations or by cataract extraction and lens implantation without keratoplasty over the past two years. Twenty-four of twenty-six grafts have remained clear over a 3- to 21-month period of observation. The two failures have been successfully regrafted. Eleven patients received a penetrating keratoplasty, cataract extraction and intraocular lens with ten remaining clear. Eight patients with corneal disease and aphakia received a penetrating graft and intraocular lens with all grafts remaining clear. Seven patients with a clear graft received a subsequent cataract extraction and lens implantation with six remaining clear. Nine patients with endothelial dystrophy and cataracts were not affected by cataract extraction and lens implantation. The relatively high success rate, rapid visual rehabilitation, and reduction in the incidence of vitreous loss, vitrectomy, and delayed vitreous complications via the methods employed have, to date, proven encouraging. Caution is advised until data from a larger case series and long-term follow-up become available. Short-term success is directly related to technique. To achieve immediate success, the need for considerable experience in keratoplasty and lens implantation can not be overemphasized.     

The use of 5-fluorouracil in patients following combined trabeculectomy and cataract extraction

We studied the effect of postoperative administration of subconjunctival 5-fluorouracil in maintaining postoperative filtration following combined trabeculectomy and extracapsular cataract extraction with posterior chamber lens implantation. Three months postoperatively, the mean intraocular pressure in 15 patients who had received 5-fluorouracil was 13.1 +/- 3.2 mm Hg; in 17 control patients, it was 13.0 +/- 3.0 mm Hg (P greater than .05). The mean number of postoperative medicines in the study patients was 0.7; in the control patients, 0.8 (P greater than .05). Bleb appearance and improvement in visual acuity were similar in the two groups. This study does not support the routine use of 5-fluorouracil in patients who have undergone combined trabeculectomy and extracapsular cataract extraction.     

Optical lamellar keratoplasty using the barraquer microkeratome

The Barraquer microkeratome may be used to cut donor and host lenticules for lamellar keratoplasty. Eleven eyes of nine patients with visually symptomatic anterior corneal opacification underwent optical lamellar keratoplasty using this technique. In three eyes, this was combined with extracapsular cataract extraction and posterior chamber intraocular lens implantation. Preoperatively, four patients had anterior stromal scars in the visual axis. There were three patients with Reis-Bückler, and two with granular corneal dystrophy. Postoperatively, visual acuity improved in ten eyes and was unchanged in one. We conclude that the Barraquer microkeratome facilitates lamellar keratoplasty and may be successfully combined with extracapsular cataract extraction and posterior chamber intraocular lens implantation. Optical lamellar keratoplasty may be an alternative to penetrating keratoplasty in selected patients with localized anterior corneal opacification.     

Glaucoma triple procedures: efficacy of intraocular pressure control and visual outcome

Sixty-three glaucoma triple surgeries [combined trabeculectomy, extracapsular cataract extraction (ECCE), and posterior-chamber intraocular lens (PC-IOL) implantation] were reviewed. Intraocular pressure (IOP) was controlled satisfactorily in all cases; 25% required additional glaucoma therapy but fewer glaucoma medications. Eighty-six percent achieved 6/12 or better visual acuity. Postoperative IOP and visual acuity results were similar to those achieved by trabeculectomy or ECCE/PC-IOL, respectively. Cumulative years of preoperative glaucoma therapy had an adverse effect on postoperative IOP control.     

Experience with the large circular loop medallion lens and a critical comparison with the suture medallion lens: a report of 300 cases.

An iris-supported intraocular lens must have stable fixation to minimize postoperative complications. A series of 46 large circular loop Medallion lenses were implanted after intracapsular cataract extraction and compared with a series of 254 suture Medallion lenses. An unexpectedly high incidence of lens dislocation and iris damage occurred with the large circular loop Medallion lens implants. Based on our results, we believe that the large circular loop Medallion lens should not be used for implantation after intracapsular cataract extraction at this time. The suture Medallion lens provides a standard to which other pseudophakai may be compared.     

Combined vitrectomy, cataract extraction, and posterior chamber intraocular lens implantation in diabetic patients

Combined extracapsular cataract extraction, pars plana vitrectomy, and posterior chamber intraocular lens implantation was performed in six eyes with proliferative diabetic retinopathy. These eyes all had minimal iris vascular changes and were at reasonably low risk for developing intraoperative and postoperative complications. The surgery must be relatively brief and the endophotocoagulation accurate. Initial visual acuities ranged from light perception to 4/200. With an average follow-up of 9.7 months, final acuities ranged from 4/200 to 20/40.     

Late postoperative hemorrhage following intracapsular cataract extraction with the IOLAB 91Z anterior chamber lens

We report 11 cases of delayed postoperative hemorrhage in a series of 134 patients who had intracapsular cataract extraction (ICCE) with implantation of an IOLAB 91Z intraocular lens.