超声乳化白内障吸出术中前房形成困难的处理和原因分析

目的：探讨白内障超声乳化吸出术中前房形成困难和持续汪前房的术中处理方法并分析其发生原因。方法：对我院1500例（眼）超声乳化白内障吸出术患者中11例出现高眼压、浅前房的患者经过高渗剂降压、升高液压、减低吸力和流速等处理，眼压降低、前房重建后完成超声乳化白内障吸出术。结果：11例患者中，10例经过上述处理后眼压下降、前房形成。1例经上述处理仍不能形成前房，经平坦部行前段玻璃体切割后前房形成。11例均可完成超声乳化术。术后视力大于或等于0．7者4例，0．3－0．5者5例，0．05者1例，手动／眼前30cm者1例。结论：房水逆流、球后出血、脉络膜腔出血是超声乳化白内障吸出术中出现前房形成困难的常见原因。大多数患者经药物处理后可重建前房，完成手术。药物处理无效时，经平坦部行前段玻璃体切割是一种有效的方法。

The Cause and Management of Acute High Intraocular Pressure in Phacoemulsification

Objective: To investigate the cause and management of acute high intraocular pressure and shallow anterior chamber in phacoemulsification.Methods: A retrospective study was done on 1 500 eyes performed phacoemulsification. Eleven of 1 500 eyes showed higher intraocular pressure and shallowing of the anterior chamber during phacoemulsification. But phacoemulsification was successfully achieved after giving hyperosmotic agents, increasing infusion pressure and reducing aspiriation rate as well as flow rate.Results: Of 11 eyes, 10 eyes were treated by management of non vitrectomy. One of 11 eyes was unresponsive to medical management and require the use of pars plana vitrectomy. Phaco was performed in all patients. In 4 of 11 eyes, visual acuity postoperatively were 0. 7 or better. Five of 11 eyes were 0. 3 to 0. 5. One eye was 0. 05 and one was HM/30cm.Conclusion: Aqueous misdirection, retrobulbar hemorrhage and intraoperative supra-choroidal hemorrhage are common causes of acute high intraocular pressure in phaco. Most of patients could be performed phaco after medical treatment. If patients failed to improve after medical treatment, par plana vitrectomy is a useful method. Eye Science 2001; 17: 82- 84.