微创晶状体玻璃体切除术治疗晶状体脱位继发青光眼

目的:探讨晶状体后脱位继发青光眼的微创玻璃体联合晶状体切除手术的疗效、安全性及并发症。方法:对我院2011年10月至2013年10月患者共26例26眼进行回顾性分析,随访时间3⁶个月。记录病因、临床表现、术前及术后最佳矫正视力、术后并发症。结果:26例晶状体后脱位继发青光眼的患者经微创玻璃体联合晶状体切除手术后,24例(占92.3%)眼压得到理想控制;20例视力明显提高(占76.9%);视神经萎缩、视网膜脱离、黄斑囊样水肿等严重并发症影响术后视力。结论:晶状体后脱位的病因不决定最佳矫正视力,而继发性青光眼、眼后节的并发症是视力低下的主要原因,采用微创玻璃体切割联合晶状体切除术是安全有效治疗晶状体后脱位继发青光眼患者的手术方法。

23-gauge transconjunctival sutureless vitrectomy and lensectomy in the management of posterior dislocation of lens with secondary glaucoma

Objective: The aim of this study is to determine the efficacy,safety and complications of 23-gauge transconjunctival sutureless vitrectomy( TSV) and lensectomy in posterior dislocation lens patients with secondary glaucoma. Methods: This retrospective and noncomparative study was carried out between 2011 and 2013. Twenty-six patients had a TSV and lensectomy for posterior dislocation lens with secondary glaucoma. The causes,presenting features,the best-corrected visual acuity before and after operation and complications were recorded. Results: The IOP( intraocular pressure) of 24 eyes was decreased to normal( 92. 3%) and final best-corrected visual acuity was better in 20 eyes( 76. 9%). Of all of the eyes,23. 1% had significant complications affecting postoperative visual outcomes,including optic atrophy,retinal detachment,cystoid macular edema. Conclusion: The cause of lens dislocation was not a predictor of visual outcomes. Nonetheless,secondary glaucoma and posterior segment complications were major causes of poor postoperative visual outcomes. These results demonstrated that TSV with lensectomy is a safe and effective surgical method for treating posterior dislocated lens with secondary glaucoma.