白内障摘出人工晶状体植入联合光学虹膜切除术的临床应用

目的:应用小切口非超声乳化白内障摘出+人工晶状体植入联合虹膜光学切除术(以下简称三联术)的方法治疗角膜混浊合并白内障,并评价其疗效。方法:选择角膜白斑、斑翳合并白内障患者13例18眼,根据角膜混浊程度、部位,设计虹膜光学切除部位。为患者施行三联手术治疗,观察术后视力恢复的情况,随访1～3mo。结果:术前视力:光感～数指12眼,<0.1者4眼,0.1～0.2者2眼。术后1wk,裸眼视力>0.3者12眼,>0.1者5眼,无改善者1眼。3mo后最佳矫正视力0.6,0.2～0.3以上的视力14眼,大部分视力不同程度的提高,全部脱盲。结论:小切口非超声乳化白内障摘出+人工晶状体植入联合虹膜光学切除术,可以一次性解决眼前段屈光间质混浊。与传统穿透性角膜移植联合白内障摘除术相比,三联术简化了手术操作,减少了角膜移植术后排斥反应等并发症,根据角膜混浊的程度、部位患者视力获得不同的恢复。三联术操作简单,安全性高,低成本低风险,值得推广。

Clinical application of non-phacoemulsification cataract extraction,intraocular lens implantation and optics iris excision

AIM:To treat the patients with opacity of the cornea and cataract that need non-supersonic emulsification cataract extraction,intraocular lens implantation and iris optics excision(tripie procedure),and to observe and analyze the clinical effects of the triple procedure·METHODS:Thirteen cases(18 eyes) with keratoleukoma and cataract were chosen,according to the opacity degree of the cornea and the spot,the iris optics excision spot was designed.The triple procedure was perfomed and postoperative visual acuity was observed.Follow-up period lasted for 1 month to 3 months postoperatively·RESULTS:The preoperative visual acuity:12 eyes were light perception and finger counting;4 eyes <0.1;2 eyes between 0.1-0.2.The postoperative naked vision: one week after surgery open hole vision of 12 eyes was over 0.3,5 eyes over 0.1,1 eye had no improvement.After 3 months,best-corrected visual acuity was 0.6,14 eyes were over 0.2-0.3,the majority of the vision had varying degree enhancement·CONCLUSION:Non-supersonic emulsification cataract extraction,intraocular lens implantation and optics iris excision can cure the patients refracting media turbidity of eye forepart and help them to get perception function at one time.Compared to the traditional penetrating corneal transplantation and cataract extraction,the iris optics excision method is simplified,and reduces the complications of rejection and so on after cornea transplantation.The tripe procedure has high safety,low cost and low risk,which is worth promoting.