| 玻璃体切除手术后的白内障超声乳化人工晶状体植入术探讨 |
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| 引用本文： | 徐艳萍,张健,施玉英,坑彩霞,刘丽丽. 玻璃体切除手术后的白内障超声乳化人工晶状体植入术探讨[J]. 国际眼科杂志, 2009, 9(5): 953-955. DOI: 10.3969/j.issn.1672-5123.2009.05.047 |
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| 作者姓名： | 徐艳萍 张健 施玉英 坑彩霞 刘丽丽 |
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| 作者单位： | 中国北京市监狱管理局中心医院眼科,100054;首都医科大学宣武医院眼科,中国北京市,100053;首都医科大学附属北京同仁医院同仁眼科中心,中国北京市,100730 |
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| 摘 要： | 目的:评价玻璃体切除术(pars plana vitrectomy,PPV)后白内障的超声乳化(phacoemulsification,Phaco)联合人工晶状体植入术(intraocular lens implantation,IOL)的临床疗效,并讨论手术技巧。方法:所有41例42眼PPV后白内障患者行激光联合超声乳化白内障手术(phacoemulsification and intraocularlens,Phaco+IOL),其中11例11眼采用玻璃体腔液体灌注+Phaco+IOL,30例31眼行Phaco+IOL,观察比较术后视力、并发症等。结果:术后1mo时矫正视力(correctedvisualacuity,CVA)较术前CVA有统计学意义的提高(P=0.002),术中玻璃体腔灌注组的术后CVA与非玻璃体腔灌注组的术后CVA比较无统计学差异(P=0.052),术后39眼CVA有不同程度的提高,术后1moCVA<0.3者19眼主要与原有眼底病有关;42眼超声乳化同期植入后房型人工晶状体,所有患者手术中均有不同程度前房深度的大幅度变化伴随瞳孔直径变化,术中发现悬韧带断裂5眼,术中后囊破裂6眼,晶状体物质掉入玻璃体腔3眼,术中发现晶状体物质与后囊紧密粘连4眼;术后并发症包括角膜水肿23眼,后发性白内障4眼,视网膜再脱离2眼。结论:在PPV后白内障行Phaco+IOL术是目前理想的手术方法,对于有复杂超声乳化因素的病历,有复杂玻璃体和眼底病史的病历,超声乳化中放置后节眼内灌注是安全而有效的。
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| 关 键 词： | 白内障 玻璃体切除术 超声乳化 人工晶状体 |
Phacoemulsification combined intraocular lens implantation for cataract patients following pars plana vitrectomy |
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| Yan-Ping Xu,Jian Zhang,Yu-Ying Shi,Cai-Xia Keng,Li-Li Liu. Phacoemulsification combined intraocular lens implantation for cataract patients following pars plana vitrectomy[J]. International Eye Science, 2009, 9(5): 953-955. DOI: 10.3969/j.issn.1672-5123.2009.05.047 |
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| Authors: | Yan-Ping Xu Jian Zhang Yu-Ying Shi Cai-Xia Keng Li-Li Liu |
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| Affiliation: | Yan-Ping Xu1,Jian Zhang2,Yu-Ying Shi3,Cai-Xia Keng1,Li-Li Liu11Department of Ophthalmology,Central Hospital of Beijing Prison Administration Bureau,Beijing 100054,China,2 Department of Ophthalmology,Xuanwu Hospital,Capital Medical University,Beijing 100053,3Tongren Ophthalmic Center,Beijing Tongren Hospital Affiliated to Capital Medical University,Beijing 100730 |
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| Abstract: | AIM:To investigate the clinical effect of cataract in vitretomized eyes with phacoemulsification (Phaco) combined intraocular lens (IOL) implantation and to disscuss surgical techniques.METHODS: Forty-one cataract cases (42 eyes) after pars plana vitrectomy (PPV) were performed Phaco combined IOL. Eleven cases (11 eyes) were with intra- infused and 30 cases (31 eyes) with no intra-infused. Corrected visual acuities(CVA) after operation one month were analyzed and complications were discussed.RESULTS:CVA was statistically high than that before operation (P=0.002). CVA was no significant differences (P=0.052) between intra- infused group and no intra- infused group.Thirty-nine eyes had enhanced CVA with different level. Nineteen eyes (CVA<0.3) had relation with fundus diseases on month before Phaco. Forty-two eyes had IOL in same time with Phaco. All the patients had remarkable change in anterior chamber depth and during in pupil diametre change operation. Five eyes were found lens ligment rupture during operation. Six eyes’ post capsular ruptured and lens materials droped into vitreous cavity in three eyes. Four eyes were found lens cortex adhering with posterior capsular.The complication include corneal edema(23 eyes), post capsular opacity(4 eyes),secondary retinal detachment(2 eyes).CONCLUSION: Phaco +IOL is an effective method for the cataract after PPV. Phaco +IOL under vitreous irrigation is an effective and safe method to the patients with complicated cataract and with complicated fundus diseases. |
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| Keywords: | cataract vitrectomy phacoemulsification intraocular lens |
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