糖尿病患者白内障超声乳化人工晶体植入术

目的 探讨糖尿病患白内障超声乳化人工晶体植入术的手术技巧及其临床疗效。方法 对30例（36眼）糖尿病患白内障利用分割碎核法进行超声乳化除联合人工晶体植入术。结果 矫正视力≥0.528眼占77.8%。术中并发症主要为后囊膜破裂,前房出血,术后并发症主要为角膜水肿,纤维素性渗出,虹膜后粘连。结论 糖尿病患白内障行超声乳化吸出联合人工晶体植入是有效的手段方式。强调术中减少对虹膜侵扰,密切观察眼底及时予以治疗。     

高血压合并糖尿病患者白内障超声乳化人工晶体植入术

目的 探讨高血压合并糖尿病白内障超声乳化人工晶体植入术的手术技巧及其临床疗效。方法 42例（42眼）高血压合并糖尿病白内障患者行白内障超声乳化联合人工晶体植入术；对照组为高血压合并糖尿病患者行白内障囊外摘除联合人工晶体植入术。采用临床对照试验方法，比较两组手术后视力、术中术后并发症的发生率。结果 白内障超声乳化组术后视力恢复明显优于囊外摘除组，并发症的发生率均低于对照组。结论 高血压合并糖尿病白内障息者行超声乳化白内障联合人工晶体植入术是安全有效的手术方式。     

糖尿病患者白内障超声乳化人工晶状体植入术的临床观察

目的：观察糖尿病患者白内障超声乳化吸出联合人工晶状体植入术的临床疗效。方法：选择36例(36眼)糖尿病患者行白内障超声乳化吸出联合人工晶状体植入术，并设36例(36眼)老年性白内障患者行白内障超声乳化吸出联合人工晶状体植入术为对照。结果：糖尿病患者白内障术后角膜内皮水肿、房水混浊、纤维素样渗出、瞳孔后粘连、后囊混浊等前段手术并发症发生率高于老年性白内障，但经过正确处理，总体预后两组并无显著性差异。结论：糖尿病患者空腹血糖控制在8．33mmoL／L以下时，行白内障超声乳化吸出联合人工晶状体植入是安全的：术中尽量减少器械在前房的操作次数，减少对角膜内皮和虹膜的损伤，能有效减少术后并发症的发生；术后使用激素眼药水滴眼，有效活动瞳孔，是治疗糖尿病患者白内障人工晶状体植入术后并发症的有效措施。     

655例白内障超声乳化联合人工晶状体植入术的临床观察

目的探讨超声乳化联合人工晶状体植入术对老年性白内障患者的手术治疗效果。方法对655例(655眼)老年性白内障患者行白内障超声乳化联合人工晶体植入术,观察术后裸眼视力恢复情况及术后并发症。结果患者术后1d裸眼视力≥0.5者256眼占39.08%,术后3天复查裸眼视力≥0.5者419眼占63.97%。655例患者裸眼视力均有不同程度提高,手术后主要并发症为角膜水肿,无其他严重并发症。结论超声乳化联合人工晶体植入术是治疗老年性白内障的有效手术方法,疗效确切,手术中规范操作可减少术后并发症的发生。     

糖尿病患者白内障手术的疗效分析

目的分析白内障现代囊外摘除人工晶体植入术和超声乳化白内障吸除人工晶体植入术治疗糖尿病性白内障的疗效及并发症。方法选择2002年1月～2004年1月期间确诊为糖尿病的白内障患者63例(69眼)，41眼Ⅱ～Ⅲ级核，采用超声乳化白内障吸除后房型人工晶体植入术；28眼Ⅳ～Ⅴ级核，采用现代白内障囊外摘除后房型人工晶体植入术。结果63例(69眼)糖尿病患者白内障术后视力均有不同程度的提高，其中58眼(84．06％)术后1周裸眼视力≥0．4。术中术后主要并发症经处理对术后视力无影响。结论采取恰当的术式，白内障现代囊外摘除人工晶体植入术和超声乳化白内障吸除人工晶体植入术治疗糖尿病性白内障疗效肯定。     

糖尿病患者白内障摘除联合人工晶状体植入术疗效观察

目的：探讨糖尿病患者白内障摘出联合人工晶状体植入术的临床疗效。方法：对87例104眼糖尿病合并白内障患者施行白内障超声乳化吸除（Phaco）和非超声乳化小切口白内障摘出术（SICS）联合人工晶状体植入术,对术后视力及并发症进行分析。结果：未发生后囊膜破裂、眼内出血、眼内炎等严重并发症。角膜水肿较重者6眼,用药后恢复透明。结论：Phaco和SICS联合人工晶状体植入术是使糖尿病白内障患者复明的主要手段,手术疗效确切。     

糖尿病患者白内障小切口非超声乳化人工晶体植入术的临床观察

目的了解糖尿病患者白内障小切口非超声乳化人工晶体植入的疗效及并发症。方法对糖尿病患者白内障与非糖尿病患者老年性白内障各48眼施行小切口非超声乳化人工晶体植入术术后视力及并发症进行临床对比观察。结果术后并发症、术后视力两组比较差异无显著性。结论空腹血糖控制在7．8mmol/L以下,小切口非超声乳化人工晶体植入术治疗糖尿病患者白内障可明显改善视力,安全有效。     

糖尿病患者白内障超声乳化吸出联合人工晶体植入术的临床观察

目的：观察糖尿病患者行白内障超声乳化吸出联合人工晶体植入术的临床效果。方法：５６例（８１只眼）糖尿病患者接受白内超声乳化吸出联合人工晶体植入术，连续随机抽取年龄相当的糖尿病患者５６例（８７只眼）作对照组，两缚白内障超声乳化吸出联合人工晶体植入手术方法相同，植入光学部直尿病患者的８７只眼中，术后矫正视力≥０．５者的７６只眼（８７％），两组经统计学处理，差异无显著性（Ｐ〉０．０５），两组术在术后并发症     

糖尿病患者白内障超声乳化术的疗效观察

目的:探讨糖尿病患者实施白内障超声乳化联合人工晶状体植入术后的治疗效果。方法:对148例164眼有糖尿病的白内障患者实施白内障超声乳化联合人工晶状体植入术,观察其术后并发症情况。结果:糖尿病患者行白内障术后并发症明显较非糖尿病者多。结论:糖尿病患者行白内障手术其并发症较多,认真进行术前准备及术后处理。手术前后的血糖平稳尤为重要。     

抗青光眼术后并发白内障的超声乳化摘除术

目的探讨抗青光眼术后白内障的超声乳化术的手术技巧,并评价手术效果.方法对41例(45眼)抗青光眼术后并发白内障的患者,行经颞侧透明角膜隧道切口的白内障超声乳化摘除和折叠式人工晶体植入术.结果除3眼术后第一天出现一过性眼压升高,其余术眼术后眼压均有所下降,但与术前比较无统计学差异.随访时矫正视力≥0.5者40眼(占89%);视力≤0.1者2眼(占4%),为绝对期青光眼患者.角膜内皮丢失率为10±3.0%.手术并发症主要是后囊破裂、晶体悬韧带部分离断和虹膜损伤.结论超声乳化吸除联合折叠式人工晶体植入术是治疗抗青光眼术后白内障的有效方法之一,应强调对角膜内皮细胞的保护和防止术后眼压的升高.     

糖尿病患者白内障超声乳化摘除和人工晶体植入

目的：分析糖尿病患者白内障超声乳化摘除和人工晶体植入的效果及并发症。 方法对９７例（１２７眼）患有糖尿病的白内障术后患者的视力及并发症进行分析，并选取同年龄段、同性别、同时期、同一手术医生施行的非糖尿病白内障患者做对照。手术采用小切口隧道式超声乳化及爱袋内人工晶体植入法。随访期为３ｍｏ。 结果９７例患糖尿病的白内障术后病人视力达 ０． ５ 及以上 ８５． ８２％，达 ０． ３及以上 ８８． ９８％。术后常见并发症为角膜水肿、晶体前沉积物、晶体前膜和后囊混浊。未合并有眼底病变或合并单纯性糖尿病视网膜病变的糖尿病患者白内障与非糖尿病白内障术后视力及术中、术后并发症比较均无显著性差异。 结论糖尿病患者白内障摘除及人工晶体植入术后，大部分视力改善满意，术后并发症少。影响术后视力的主要原因是糖尿病视网膜病变合并黄斑病变。     

轴性高度近视白内障超声乳化与负度数人工晶体植入术

目的：探讨轴性近视并发白内障超声乳化摘除与负度数人工晶体植入术的临床疗效。方法：22例（38眼）眼轴长31．5－34．5mm,局麻或表麻下行颞侧透明角膜隧道切口的白内障超声乳化摘除术,植入－1D－－8D人工晶体,观察术中、术后并发症及术后视力。结果：术后矫正视力大于0．3者16眼（42．11％）;矫正视力大于0．5者12眼（31．58％）。术中2眼发生后囊膜破裂,其中一眼伴脉络膜上腔出血。术后14眼（36．84％）发生后发性白内障,仅4眼需行Nd:YAG激光切开术。术后无视网膜并发症。结论：轴性高度近视白内障超声乳化摘除与负度数人工晶体植入术,可以减少病人术后残余的屈光不正,防止视网膜并发症。     

高度轴性近视眼白内障小切口非超声乳化及人工晶状体植入术

目的:观察高度轴性近视眼白内障行小切口非超声乳化及人工晶状体植入术的临床疗效,分析影响术后视力的因素。方法:对我院158例186眼眼轴≥26mm的高度近视眼白内障行小切口非超声乳化及人工晶状体植入术,术后随访6mo,观察术后视力和术中术后并发症情况。结果:术后3mo裸眼视力≥0.5者145眼(78%),0.1~0.4者33眼(18%),<0.1者8眼(4%);并发症有后囊膜破裂11眼,角膜内皮水肿19眼,视网膜脱离3眼,后囊膜不同程度混浊13眼。结论:高度轴性近视眼白内障行小切口非超声乳化及人工晶状体植入术疗效良好,是一种安全性较高的理想的手术方法。     

Secondary intraocular lens implantation in aphakia.

We retrospectively studied secondary intraocular lens (IOL) implantation in 165 aphakic patients (162 eyes) from May 1983 to August 1989. Seventy-five eyes (46.3%) had secondary IOL implantation; these included seven cases of trans-sulcus scleral fixation of the posterior chamber lens. The remaining 87 eyes could not have secondary IOL implantation because of the ocular conditions. The most common reason for secondary implantation was to relieve the discomfort caused by spectacles or contact lenses (56.2%). An anterior chamber lens was used in 43 eyes (57.3%) and a posterior chamber lens in 32 eyes (42.7%). Final postoperative visual acuity of 20/40 or better was achieved in 92.0% of the eyes with posterior chamber lenses, in 71.4% of the eyes with anterior chamber lenses, and in 57.1% of the eyes with scleral-fixated posterior chamber lenses. Endothelial cell loss was greater in the eyes with anterior chamber lenses than in the eyes with posterior chamber lenses. Of the cases that could be followed, 83.3% showed endothelial cell loss of less than 30% at six months postoperatively. Postoperative complications such as cystoid macular edema, persistent fibrinous membrane formation, and neovascular glaucoma occurred in only ten (13.3%) of the 75 eyes that had secondary implantation. These complications occurred more frequently in eyes that had anterior chamber lenses with anterior vitrectomy. There were no noticeable complications in the eyes that had trans-sulcus scleral fixation of posterior chamber lenses. Updrawn pupil, prolapsed vitreous, and peripheral anterior synechia were common conditions preventing secondary IOL implantation.     

儿童人工晶状体植入术临床观察

目的 探讨儿童人工晶状体植入的最佳时机、屈光度选择及并发症的防治。方法 57例67眼先天性和外伤性白内障，年龄2岁至12岁，行白内障摘出并后房型人工晶状体植入术，术后随访2－14月。结果 除10例患儿不合作，其余患儿术后视力均较术前有所提高，≥0．5为28眼，占53％。术后并发症主要为后囊浑浊，23眼行Ⅱ期后囊切开或YAG激光治疗。其他并发症包括葡萄膜炎、瞳孔多位、人工晶状体瞳孔夹持等。结论 人工晶状体植入术是目前儿童白内障较为理想的复明手段，但应掌握手术时机，及时妥善处理术后并发症。     

后房型人工晶状体缝线固定术后并发症的临床观察

目的：探讨后房型人工晶状体睫状沟缝线固定术在白内障术中韧带断裂及后囊破裂后人工晶状体二期植入,外伤性白内障、晶状体脱位等无晶状体后囊膜术眼中的应用及术后并发症。

方法：选取我科2007-02/2012-11 采用后房型人工晶状体缝线固定术患者31例32眼,均获得较满意的效果。

结果：术后随访3mo～1a,矫正视力>0.5者9眼(28%); 0.1～0.5者17眼(53%); <0.1者6眼(19%)。出现术中睫状体穿刺口出血、术后角膜水肿、角膜散光、悬吊线松弛断裂、人工晶状体偏位等主要并发症。

结论：后房型人工晶状体缝线固定术是目前无后囊或后囊膜晶状体悬韧带大范围缺损的手术首选,但还有许多手术并发症有待进一步解决。     

外伤性白内障手术的疗效分析

目的：评价外伤性白内障的手术效果。方法：对56例（58眼）各种原因所致的外伤性白内障施行手术治疗,其中44眼行现代白内障囊外摘出或超声乳化术,同时一期后房人工晶状体植入;5眼二期后房人工晶状体植入;6眼前房人工晶状体植入;3眼人工晶状体缝线固定术。结果：术后视力0.4－1.0者39眼占67.2％,并发症主要为后囊破裂玻璃体脱出、角膜水肿、人工晶状体前膜及后发障。结论：外伤性白内障虽病情复杂,并发症较多,但通过精细手术和术前术后的合理治疗仍可获得满意疗效。     

Pars plana vitrectomy with posterior iris claw implantation for posteriorly dislocated nucleus and intraocular lens

We evaluated the safety and efficacy of pars plana vitrectomy (PPV) with primary posterior iris claw intraocular lens (IOL) implantation in cases of posterior dislocation of nucleus and IOL without capsular support. This was a retrospective interventional case series. Fifteen eyes underwent PPV with primary posterior iris claw IOL implantation performed by a single vitreoretinal surgeon. The main outcome measures were changes in best corrected visual acuity and anterior and posterior segment complications. A total of 15 eyes were included in this study. Eight had nucleus drop, three had IOL drop during cataract surgery and four had traumatic posterior dislocation of lens. The final postoperative best corrected visual acuity was 20/60 or better in 11 patients. This procedure is a viable option in achieving good functional visual acuity in eyes without capsular support.     

糖尿病患者反眉弓巩膜瓣切口白内障摘除人工晶状体植入术临床体会

目的:探讨糖尿病患者反眉弓巩膜瓣切口白内障摘除人工晶状体植入术效果及并发症。方法:对26例28眼糖尿病患者白内障采用反眉弓巩膜瓣切口后房性人工晶状体植入术。结果:26例28眼糖尿病患者白内障术后视力均有不同程度提高,术后视力>0.3以上达64.3%,并发症包括:术中悬韧带断裂1眼,后囊膜破裂2眼,术后角膜上皮水肿及内皮皱褶18眼,房水闪辉(+～++)20眼,前房出血2眼,术后眼压增高3眼,瞳孔区纤维素膜渗出形成3眼。结论:我们体会糖尿病患者白内障在严格控制血糖的基础上进行手术疗效满意,提高手术技能,缩短手术时间可以减少并发症。     

Surgical treatment and visual outcomes of cataract with persistent hyperplastic primary vitreous

AIM: To evaluate the surgical treatment and visual outcomes of eyes with cataract and persistent hyperplastic primary vitreous (PHPV). METHODS: This retrospective study included patients with cataract and PHPV treated with various strategies. Anterior PHPV was treated using phacoemulsification with underwater electric coagulation on posterior capsule neovascularization, posterior capsulotomy, anterior vitrectomy, and intraocular lens (IOL) implantation. Posterior PHPV was treated with lensectomy, posterior vitrectomy, retinal photocoagulation, and IOL implantation or silicone oil tamponade. Visual acuity (VA), pattern visual evoked potential (P-VEP), anatomic recovery, postoperative complications, and amblyopia outcome were examined. Subjects were followed-up for 3-48mo after surgery. RESULTS: Of the 30 patients (33 eyes) with congenital cataract and PHPV included (average age, 39.30±35.47mo), 9 eyes had anterior PHPV and 24 had posterior PHPV. Thirty-two eyes were surgically treated. Eyes with anterior PHPV received an IOL during one-stage (6 eyes) and two-stage (3 eyes) implantation. Postoperative complications included retinal detachment (1 eye) and recurrent anterior chamber hemorrhage (1 eye). In eyes with posterior PHPV, 6 and 11 eyes received IOLs in one- and two-stage procedures, respectively. Silicone oil was retained in 2 eyes, and IOLs were not implanted in 4 eyes. VA significantly improved in 25 eyes following operations and 3-48mo of amblyopia treatment. P-VEP P100 was improved following surgery in both PHPV types. CONCLUSION: Our surgical strategies are appropriate and effective for anterior and posterior PHPV. Early surgical intervention and amblyopia therapy result in positive treatment outcomes.