角膜穿通伤合并外伤性白内障的手术探讨

目的探讨角膜穿通伤合并外伤性白内障的手术方式和手术时机与疗效的关系。方法总结了近5年来本院收治的47例角膜穿通伤合并外伤性白内障的患者，并对手术时机和术式的选择进行了总结和探讨。结果15例行角膜清创缝合术的同时行外伤性白内障吸除术，12例1期植人工晶体，15例清创缝合后3～6d行皮质吸除加人工晶体植入术。11例清创缝合2周后吸除残余皮质同时植入人工晶体。其中植入后房型人工晶体38例，9例未行人工晶体植入。术后3月复查，植入人工晶体的27眼裸眼视力0．2～0．6，47眼矫正视力在0．06～0．8。结论角膜穿通伤合并外伤性白内障，1期行清创缝合和白内障摘除联合人工晶体植入或2期白内障摘除联合人工晶体植入预后能获得较好的视力。

Efficacy evaluation of operation therapy in penetrating corneal trauma complicating with traumatic cataract

Objective To explore the relationship of the modus operandi and opportunity for penetrating corneal trauma complicating with traumatic cataract and its therapeutic effect. Methods Data of 47 patients of penetrating cornea1 trauma complicating with traumatic cataract in recent 5 years were reviewed, and the modus operandi and opportunity were summarized and analyzed. Results 15 patients underwent cataract extraction and corneal debridement and suturing, and 12 patients were implanted intraocular lens （IOL）. 15 patients underwent cataract extraction and IOL implantation 3 to 6 days after wound suture. 11 patients underwent cataract extraction and IOL implantation 2 weeks after wound suture. 38 cases underwent the posterior chamber type artificial lens implantation, and 9 cases didn＇t undergo intraocular lens implantation. Three months later, vision acuity was 0.2 to 0.6 of 27 IOL eyes, and corrected vision acuity was. 0.06 to 0.8 of 47 IOL eyes. Conclusion Cataract extraction and wound suture or cataract extraction later can obtain good vision prognosis for penetrating corneal trauma complicating with traumatic cataract.