白内障超声乳化人工晶状体植入术843例

目的：探讨白内障超声乳化及人工晶状体植入术的手术技巧和并发症的预防和处理，并观察术后疗效。方法：对843例白内障患实施了白内障双手原位超声乳化囊袋内人工晶状体植入术。结果：术后第1天视力≥4．7683例（81％），4．0－4．7160例（19％），后囊破裂42例（5％），角膜内皮水肿42例（5％），结论：双手原位超声乳化及人工晶状体植入术具有切口小，术后散光少，视力恢复快及手术成功率高等优点。     

超声乳化人工晶状体植入术治疗糖尿病患者白内障

目的：探讨超声乳化人工晶状体植入术治疗糖尿病患者白内障的疗效观察。 方法：糖尿病患者白内障80例106眼,施行透明角膜切口白内障超声乳化及折叠式人工晶状体植入,观察手术并发症及术后视力、切口愈合情况。 结果：所有患者手术顺利,均Ⅰ期植入晶状体在囊袋内。术后3mo,裸眼视力≤0.1者6眼(5.7％),0.2～0.5者28眼(26.4％), 0.6～1.0者72眼(67.9％)。术后无感染,切口愈合良好。 结论：超声乳化折叠人工晶状体植入术是治疗糖尿病患者白内障安全的、有效的方法。     

晶状体超声乳化人工晶状体植入术的临床观察

目的探讨白内障施行晶状体超声乳化人工晶状体植入术的特点、手术技巧、并发症及防治措施。方法对65眼白内障施行无缝线5.5mm切口超声乳化人工晶状体植入术。结果术后第1天裸眼视力≥0.5者38眼(58.46%),术后1周视力≥0.5者47眼(72.31%);术后1月视力≥0.5者53眼(81.54%)。术中术后主要并发症有后囊破裂3例(5眼,7.69%);角膜内皮水肿9例(11眼,16.92%)。结论采用无需缝合的反眉状隧道式切口行晶状体超声乳化人工晶状体植入术可获较佳视力,而手术成功的关键在手术者的手术方法和操作技巧。     

白内障超声乳化人工晶状体植入临床分析

目的探讨白内障超声乳化及人工晶状体植入术的效果、手术方法及并发症的防治。方法对473例(495眼)白内障行超声乳化吸出及人工晶状体植入术进行观察和分析。结果术后1周矫正视力1．0以上为147眼(29．70％)，术后3月矫正视力1．0以上者341眼(68．90％)，0．5以上者476眼(96．16％)。主要并发症术中为后囊破裂和虹膜损伤，术后为角膜内皮水肿。结论超声乳化白内障吸出联合后房型人工晶状体植入术具有术后早期反应少及术后视力提高迅速的优点。     

小切口白内障囊外摘出与超声乳化白内障摘出效果比较

目的 比较小切口白内障囊外摘出人工晶状体植入术与超声乳化白内障吸出硬质人工晶状体植入术两种方法的临床效果。方法 分别对140只眼小切口非超声乳化白内障囊外摘出术及154只眼超声乳化硬质人工晶状体植入术的术后视力、角膜内皮丢失率，术中、术后并发症进行比较。结果 小切口非乳化组1周后视力＞0．5者115只眼(82．2％)，＜0．4者25只眼(17．8％)。超声乳化组＞0．5者128只眼(83．1％)，＜0．4者26只眼(16．9％)。角膜内皮丢失率，小切口非超声乳化组13．2％，超声乳化组12．8％。术后角膜内皮水肿：小切口非乳化组11只眼(7．86％)，超声乳化组10只眼(6．49％)。结论 小切口非超声乳化白内障摘出与超声乳化硬质人工晶状体植入术疗效相似，前者简便、易行、经济，适宜于基层医院开展。     

表面麻醉下晶状体超声乳化临床观察

目的观察表面麻醉在晶状体超声乳化白内障摘出及人工晶状体植入术中的麻醉效果。方法采用表面麻醉对198例(212眼)进行晶状体超声乳化白内障摘出及人工晶状体植入术。结果212眼均在表面麻醉下完成手术,术后1周最佳视力≥0.5者176眼(83.02%),术后1月最佳视力者≥0.5者200眼(94.34%)。主要并发症:后囊破裂6眼(2.83%),中度角膜水肿4眼(1.89%)。结论表面麻醉下行晶状体超声乳化白内障摘出人工晶状体植入术是安全、有效的。     

超声乳化治疗糖尿病患者白内障的临床分析

目的探讨糖尿病患者白内障进行超声乳化吸出人工晶状体植入术的疗效和并发症。方法对42例(46眼)糖尿病患者的白内障施行3.5mm角巩膜隧道切口,晶状体超声乳化吸出,植入折叠式人工晶状体。结果术后1天视力≥0.6者28眼(60.87%);术后3月视力≥1.0者27眼(58.7%)。术后1月角膜散光平均为(1.12±0.48)D,与术前对比,差异无统计学意义(P>0.05)。术中后囊破裂1眼;术后轻度角膜水肿7眼(15.22%),房水闪光5眼(10.87%),均于1周内消退;后囊浑浊1眼。结论采用晶状体超声乳化吸出折叠式人工晶状体植入术治疗糖尿病患者的白内障,术后并发症较少,视力恢复尚好,手术是安全的、有效的。     

多焦点人工晶状体植入术的初步报告

目的 评价白内障超声乳化摘除联合多焦点人工晶状体植入术後的临床效果。方法 对32例41眼白内障患者施行白内障超声乳化摘除联合多焦点人工晶状体植入术,观察术后远视力、近视力、眼屈光状态、眼压、角膜内皮细胞及角膜曲率等变化以及并发症等。结果 32例41B艮多焦点人工晶状体植入术后远视力平均为0.76(0.25～1.5),≥1.0者14眼(34.2％);≥0.3者39眼(95.1％);术后近视力平均为0.72(0.2～1.5),≥1.0者13眼(31.7％);≥0.3者39眼(95.1％)。术眼角膜内皮细胞均较术前减少,丢失率为9.43％。术后出现眩光感患者3例(7.3％)。结论 白内障患者施行超声乳化摘除联合多焦点人工晶状体植入术后不需佩戴矫正眼镜亦具有良好的远视力和近视力,获得较高的生活质量,虽然部分患者出现眩光现象,但均无明显不适感,对术后效果仍选择满意答案。     

白内障超声乳化及人工晶状体植入术临床研究

目的 探讨白内障超声乳化吸出术及后房型人工晶体植入术的临床效果。方法 对673例(697眼)进行白内障超声乳化术及人工晶状体植入术观察术中及术后并发症。术后随访3月，观察视力。结果 术后1天、7天、3月视力≥0．5分别为23％、56％、81．3％。术中、术后并发症主要为角膜水肿、后发性白内障、后囊破裂及玻璃体脱出、虹膜脱出。结论 超声乳化白内障摘出术成功的关键在于手术技巧和手术的熟练程度。     

超声乳化人工晶状体植入术影响视力因素分析

目的　分析超声乳化吸出人工晶状体植入影响视力因素。方法　对 196例 2 19眼白内障超声乳化吸出人工晶状体植入术影响视力因素进行分析。结果　术后 1月 ,矫正视力 :<0 .5者 5 6眼 (2 5 6% ) ,0 .5～ 0 .9者 94眼 (4 2 .9% ) ,≥ 1 0者69眼 (3 1 5 % )。影响视力的主要因素 :术后并发症如角膜水肿及失代偿、后囊浑浊、葡萄膜炎、人工晶状体偏位及术前合并眼病。结论　白内障超声乳化吸出人工晶状体植入术中减少术中术后并发症 ,可提高术后视力     

糖尿病患者白内障行晶状体超声乳化术的临床疗效观察

目的分析糖尿病患者晶状体超声乳化人工晶状体植入术临床疗效及并发症。方法对36例（42眼）糖尿病患者晶状体超声乳化人工晶状体植入术临床资料进行回顾性分析。结果 42眼手术后随访12月,术后视力≥0.6者33眼,占78.57%。结论糖尿病患者血糖控制在理想范围内再行晶状体超声乳化人工晶状体植入术是可行的。     

葡萄膜炎并发白内障手术治疗的临床观察

目的　探讨葡萄膜炎并发白内障手术治疗的方法和临床效果。方法　３３例（３３眼）葡萄膜炎并发白内障患者行超声乳化人工晶状体植入术治疗,术前和术后给予泼尼松联合环磷酰胺治疗。术后观察视力、眼压、并发症以及葡萄膜炎复发等情况。术后随访６个月。结果　３３眼术后视力均有不同程度提高。术后最佳矫正视力≤０．１者３眼（９．０９％）,＞０．１～＜０．５者１１眼（３３．３３％）,０．５～＜１．０者１４眼（４２．４２％）,≥１．０者５眼（１５．１５％）。术后并发症包括后发性白内障２眼（６．０６％）,虹膜轻微后粘连６眼（１８．１８％）,白细胞数量轻度降低１例（３．０３％）。术后眼压均控制在正常范围内。随访期内未见葡萄膜炎复发。结论　葡萄膜炎并发白内障行白内障超声乳化人工晶状体植入术,术前和术后给予小剂量糖皮质激素联合环磷酰胺治疗效果较好,便于临床应用。     

Comparative study of postoperative complications in primary and secondary implantation of posterior chamber intraocular lens in cataract surgery for diabetic patients]

Postoperative complications of diabetic cataract cases with active stage diabetic retinopathy, which underwent simultaneous extracapsular lens extraction (ECCE) and posterior chamber intraocular lens (PC-IOL) implantation in 84 eyes, ECCE only in 38 eyes and secondary implantation of PC-IOL after ECCE in 23 eyes, were studied. In the eyes of the primary PC-IOL implantation group, fibrous response in 35 eyes (42%), posterior iris synechia in 10 eyes (12%), progression of diabetic retinopathy in 13 eyes (16%), after cataract in 11 eyes (13%), pupil capture in 4 eyes (5%) and decentration of lens optics in 3 eyes (4%) were appeared, while in the ECCE only group, fibrous response in 11 eyes (29%), posterior iris synechia in 4 eyes (11%), after cataract in 11 eyes (29%), progression of diabetic retinopathy in 6 eyes (16%) were observed. On the other hand, in the secondary PC-IOL implantation group, only fibrous response was appeared in 1 eye (4%), Although PC-IOL implantation has been so far considered contraindication in cases with cataract combined with active stage retinopathy, the present studies strongly suggest that secondary PC-IOL implantation would be good indication in these cases whose blood sugar was properly controlled and the retinopathy was burned out by panretinal photocoagulation soon after ECCE.     

LASEK治疗白内障摘除联合IOL植入术后屈光不正的观察

目的:观察准分子激光上皮下角膜磨镶术(LASEK) 治疗白内障摘除联合人工晶状体植入术后屈光不正的安全性及疗效。方法:对白内障摘除联合人工晶状体植入术后屈光不正的42例49眼施行LASEK,术后随访6mo以上,记录角膜地形图、视力、屈光度数、角膜haze等情况。结果:术后6mo裸眼视力≥1.0者32眼(65.3%),≥0.8者42眼(85.7%)。球镜度数±1.0D内者为45眼(91.8%),±0.5D内者为34眼(69.4%)。柱镜度数±1.0D内者43眼(87.8%),±0.5D内者为31眼(63.3%)。术后6mo 0.5级haze 4眼(8.2%),其余均为0级,无继发性圆锥角膜、继发性青光眼、切削偏中心等并发症。结论:LASEK治疗白内障人工晶状体植入术后屈光不正屈光不正安全性高,疗效确切。     

超声乳化人工晶状体植入治疗葡萄膜炎并发性白内障

目的：探讨白内障超声乳化联合人工晶状体植入手术治疗葡萄膜炎并发性白内障的手术疗效。
　　方法：本研究采用系统性回顾研究,选取2015-01/12在南京军区南京总医院眼科诊断为葡萄膜炎并发性白内障的患者57例57眼,所有患者均行白内障超声乳化联合人工晶状体植入术,对患者的术中并发症,术后效果及并发症情况进行回顾分析。对手术前后视力进行非参数Wilcoxon检验。
　　结果：所选患者超声乳化术中发生虹膜出血21眼(37%),后囊膜破裂4眼(7%),人工晶状体无法植入4眼(7%),术后裸眼视力获得不同程度提高,术前裸眼视力≥0.1者8眼(14%),术后3mo裸眼视力≥0.1者42眼(74%),差异有统计学意义(Z=23.42,P<0.001)。术后1 d发生角膜水肿17眼(30%)、葡萄膜炎2眼(4%)、高眼压1眼(2%),术后1wk发生角膜水肿3眼(5%),术后1mo发生葡萄膜炎1眼(2%),术后3mo发生角膜水肿1眼(2%)、葡萄膜炎2眼(4%)、高眼压1眼(2%)、后发性白内障3眼(5%)。
　　结论：白内障超声乳化联合人工晶状体植入手术治疗葡萄膜炎并发性白内障,术后效果好,并发症少。     

Cystoid macular edema in anterior chamber lens implantation following posterior capsule rupture

By comparing the incidence of cystoid macular edema (CME) in three groups of patients having different surgical procedures, we attempted to assess the role of vitreous loss as a risk factor for CME development. In the first group (n = 470), the surgical procedure was extracapsular cataract extraction followed by implantation of posterior chamber lens (EC-CE + PC-IOL). The second group (n = 42) had extracapsular cataract extraction which was complicated by posterior capsule rupture, and therefore anterior vitrectomy followed by implantation of anterior chamber lens had to be performed (ECCE + anterior vitrectomy + AC-IOL). In the third group (n = 22) the surgery was intracapsular cataract extraction followed by anterior chamber lens implantation (ICCE + AC-IOL). The third group was included in this follow up study to assess the role of AC-IOL as a possible causative factor for development of CME in uncomplicated cases of ICCE and AC-IOL. The difference of incidences of CME in the second and third group would therefore depend mostly on the vitreous loss. The incidence of CME diagnosed by fluorescein angiography in the first, second and third group was 1.5% (7/470), 35.7% (15/42) and 9.0% (2/22), respectively. All patients who developed CME were treated with combination of corticosteroid-antibiotic drops, dexamethasone retrobulbarly (40 mg/day) and peroral indomethacine (25 mg/day/6 weeks). This therapeutic regime resulted in only moderate improvement of visual acuity.Abbreviations AC-IOL anterior chamber intraocular lens - CME cystoid macular edema - ECCE extracapsular cataract extraction - ICCE intracapsular cataract extraction - IOL intraocular lens - PC-IOL posterior chamber intraocular lens     

糖尿病患者小切口白内障摘出人工晶状体植入

目的探讨糖尿病患者手法小切口白内障摘出联合人工晶状体植入的安全性和疗效。方法对112例（138眼）糖尿病患者施行手法小切口白内障摘出联合人工晶状体植入;并以114例（139眼）非糖尿病老年性白内障作对照组。术后对合并糖尿病视网膜病变的42眼中的36眼于术后1—2个月行视网膜激光光凝。结果随访6—12个月,术后3个月视力〉10．3者,糖尿病组合并视网膜病变者18眼,占42．86％;未合并视网膜病变者85眼,占88．54％。非糖尿病组视力≥0．3者129眼,占92．81％。糖尿病组合并视网膜病变者与非糖尿病组差异有统计学意义（χ2=52．75,P〈0．01）;未合并糖尿病视网膜病变者与非糖尿病组差异无统计学意义（χ2=1．27,P〉0．05）。结论对糖尿病患者白内障施行手法小切口白内障摘出联合人工晶状体植入术是安全的,为便于术后观察眼底,及时治疗视网膜病变提供了条件。     

Cataract surgery with the AlphaCor artificial cornea

PURPOSE: To review the outcomes of AlphaCor artificial cornea (Argus Biomedical Pty Ltd.) implantation concurrent with or subsequent to cataract surgery. SETTING: Nonrandomized multicenter clinical trial. METHODS: AlphaCor devices were implanted under an approved protocol. Extracapsular cataract extraction with intraocular lens implantation was concurrently performed in 5 cases; an additional case had a displaced cataractous lens removed after severe blunt trauma subsequent to AlphaCor implantation. RESULTS: Cataract surgery was difficult because the view was restricted and residual soft lens matter was retained. There was an increased incidence of postoperative complications (eg, melt, glaucoma) in cataract cases compared with noncataract AlphaCor cases. The mean best corrected visual acuity was worse in cases with cataract than in cases without. CONCLUSIONS: The technique for cataract surgery in AlphaCor cases needs to be refined. Imaging studies performed postoperatively may help ascertain whether soft lens matter remains so additional antiinflammatory medication can be considered. Melting appears to be preventable by topical medroxyprogesterone 1% therapy.     

Posterior capsule folds and removal of ophthalmic viscosurgical devices

PURPOSE: To evaluate the relationship between posterior capsule folds and an ophthalmic viscosurgical device (OVD) during cataract surgery. SETTING: Parkland Memorial Hospital, Dallas, Texas, USA. METHODS: A prospective observational study of 91 consecutive uneventful cataract extractions by phacoemulsification was performed. The presence or absence of posterior capsule folds was noted immediately after intraocular lens (IOL) implantation and after OVD removal. RESULTS:Posterior capsule folds were present in 21 of 49 cases (43%) with an MA60BM lens (Alcon Laboratories) and in 1 of 42 cases (2%) with an SA30AL lens. In the MA60BM group with folds, the folds were noted before OVD removal in 14 cases and after OVD removal in 16 cases. There was no significant difference in age, sex, axial length, horizontal corneal diameter, or IOL power between groups with and without posterior capsule folds. CONCLUSIONS: The presence of posterior capsule folds does not reliably signify the complete removal of OVDs.     

角膜伤口修补白内障摘除联合人工晶体植入术

目的：评价角膜伤口修补、白内障摘除联合人工晶体植入术的临床疗效。方法：对36例角膜穿通伤患者施行角膜伤口修补的同时行白内障摘除联合人工晶体植入术。人工晶体前膜、后发性白内障给予YAG激光切除。角膜中央疤痕严重影响视力者行穿透性角膜移植术。对所有病例进行3－12个月的随访。结果：术后末次随访时裸眼视力0．1－0．3者8例（22．8％）,0．4－0．5者14例（40％）,0．6－0．8者13例（37．1％）。无因人工晶体植入术引起的严重并发症。结论：只要能准确地把握好手术适应症,在角膜伤口修补的同时行人工晶体植入术能取得较好的疗效。