瞳孔成形联合白内障超声乳化吸除术的短期效果

目的 探讨虹膜瞳孔异常合并白内障者行瞳孔成形联合白内障超声乳化吸除人工晶状体（IOL）植入术的短期疗效。设计 回顾性病例系列。研究对象 2009年10月至2011年8月诊治的因多种原因导致虹膜瞳孔异常合并白内障的患者59例（62眼）。方法 依瞳孔大小、形状及虹膜条件采用瞳孔成形联合白内障超声乳化吸除IOL植入和（或）前段玻璃体切割术。术后随访3～6个月。主要指标 视力、眼压及瞳孔形态。结果 术前裸眼视力＞0.5者7眼（11.3%）；小瞳孔者36眼（58%），钝挫伤伴虹膜根部离断者14眼（22.6%），先天性虹膜缺损者8眼（13.0%），外伤性无虹膜者4眼（0.06%）；高眼压者8眼（13.0%）。术后59眼（95.0%）视力提高，裸眼视力＞0.5者23眼（37.1%）；术后62眼（100%）瞳孔呈圆形或类圆形，瞳孔位于中央或近中央，瞳孔偏位3眼（0.05%）。33眼（53.2%）瞳孔直径2.5～4.0 mm。术中1眼前房出血；术后1周6眼眼压升高，其中3眼行抗青光眼手术及药物治疗；术后1个月3眼眼压升高；术后3～6个月眼压均正常。结论 瞳孔成形联合白内障超声乳化吸除IOL植入术治疗虹膜瞳孔异常合并白内障安全、有效。（眼科，2012, 21： 86-89）

The short-term efficacy of coreoplasty combined with cataract phacoemulsification

Objective To evaluate the short-term effects of coreoplasty combined with phacoemulsification and intraocular lens(IOL) implantation for pupil abnormality and cataract.Design Retrospective case series.Participants Pupillary abnormalities combined with cataract patients 59 cases(62 eyes).Methods Coreoplasty combined with phacoemulsification and IOL implantation and(or)vitrectomy of anterior segment were performed based on pupil size,shape and iris condition in 2009-2011.All patients were followed up for 3-6 months.Main Outcome Measures Visual acuity,intraocular pressure(IOP) and iris morphology.Results The preoperative uncorrected visual acuity was better than 0.5 in 7 eyes(11.3%).Small pupil was in 36 eyes(58%).Eye injury with IOP was in 14 eyes(22.6%).Congenital iris coloboma was in 8 eyes(13%).Traumatic aniridia was in 4 eyes(0.06%).IOP increased in 8 people(13%),averaging IOP(32.50±2.50) mm Hg.At the last follow-up,postoperative visual acuity improved in 59 eyes(95%).The uncorrected visual acuity was better than 0.5 in 23 eyes(37.1%).After surgery in 62 eyes(100%) pupil was round or nearly round,and at central or nearly central position.In 3 eyes(0.05%)pupil was displacement.In 33 eyes(53.2%) pupil diameter was 2.5~ 4.0 mm.Hyphema occurred in 1 eyes intraoperatively.After 1 weeks in 6 eyes existed elevated IOP,averaging IOP(29.0±3.5) mm Hg,of which 3 eyes were performed hypotensive surgery.At 1 month after coreoplasty surgery 3 eyes existed elevated IOP,averaging(24.5±3.5)mm Hg.After 3 to 6 months the IOP in all patietns was normal.Conclusions Coreoplasty combined with phacoemulsification and IOL implantation for the treatment of pupillary abnormalities with cataract patients is safe,effective.