白内障术后盲及低视力的原因和防治方法

目的分析白内障手术后盲及低视力的原因和防治方法。方法收集资料完整的年龄≥20岁白内障超声乳化吸出术连续病例915例（991眼），术后随访3个月，对盲及低视力的原因和防治方法进行回顾性分析。结果术后1d、1周、1个月和3个月时盲及低视力者依次为170例（183眼）、129例（138眼）、113例（121眼）和105例（113眼）。白内障术后早期（1周内）导致盲及低视力的主要原因是手术并发症，依次为角膜水肿、一过性高眼压、后囊破裂。术后中远期（1—3个月）导致盲及低视力的主要原因是术前原有的眼病，其中眼底病占79．64％，依次为糖尿病性视网膜病变、高度近视、青光眼视神经萎缩等。结论减少手术并发症和术前及术后治疗术前原有的眼病，是防治白内障术后盲及低视力的主要方法。

Causes and preventive methods of blindness and low vision after cataract surgery

Objective To investigate the causes and preventive methods of blindness and low vi- sion after cataract surgery. Methods The complete data of 991 eyes of 915 consecutive cases aged over twenty years and treated with cataract phacoemulsification were collected. The causes and preventive methods of blindness and low vision after the surgery were retrospectively analyzed followed up for 3 months after sur- gery. Results The blindness and low vision were found in 183 eyes of 170 cases, 138 eyes of 129 cases, 121 eyes of 113 cases and 113 eyes of 105 cases at 1 d, 7 d, 30 d and 90 d after surgery respectively. In the early time of post-operation, the main causes of blindness and low vision were surgical complications, inclu- ding corneal edema, transient high intraocular pressure and posterior capsular rupture. The main mid and long term causes were preoperative original eye diseases, the most common of which was fundus lesion, ac- counting for 79.64%, followed by diabetic retinopathy, high myopia and glancomatous optic atrophy. Con- clusion Minimization of surgical comphcations and treatment of preoperative original eye diseases are the main preventive methods for post-operative blindness and low vision after cataract surgery.