超声乳化术治疗中青年单眼白内障临床分析

目的探讨白内障超声乳化吸除人工晶状体植入术治疗中青年单眼白内障临床疗效及手术适应证。方法共26例（26只眼）,其中男11例（11只眼）,女15例（15只眼）,年龄21-48岁,平均37.5岁。除1例（1只眼）术前视力为0.6外,其余手术眼视力均〈0.4,而非手术眼视力均在0.6以上。其中合并远视力3只眼,合并有高度近视9只眼（其中准分子激光治疗术后2只眼,有角膜散光〉-1.00 D者3只眼）,合并糖尿病3只眼,合并葡萄膜炎3只眼,眼外伤2只眼,玻璃体切割术后1只眼,无明显诱因3只眼。术前常规检查及人工晶状体度数测量,局麻下行白内障超声乳化吸除人工晶状体植入术。其中3例（3只眼）植入散光型人工晶状体（Acrysof Toric IOL）。26例患者非手术眼佩戴隐形眼镜者7例（7只眼）,2例（2只眼）行准分子激光原位磨镶术。结果所有患者视力均有不同程度提高,其中无明显诱因者术后视力达1.2。3例（3只眼）Toric人工晶状体植入术者,不仅视力提高,追踪半年以上,人工晶状体表袋内视轴稳定,无明显不适。屈光参差较大者,非手术眼屈光不正配戴隐形眼镜或准分子激光治疗,均获得较好双眼单视功能。结论超声乳化及人工晶状体植入术治疗中青年单眼白内障患者,效果肯定,无明显并发症;根据中青年年龄特点、非手术眼屈光度情况及工作生活需要,可适当放宽手术眼在视力上的适应证。而对于术后双眼屈光参差较严重者,可根据非手术眼屈光度配戴隐形眼镜或行准分子激光治疗,以建立双眼单视功能,提高生活质量。

Phacoemulsification and intraocular lens implantation in the treatment of monocular cataract in young and middle-aged patients

Objective A retrospective study tocharacterize surgical indicationsand outcomes of phacoemulsification and intraocular lens implantation for monocular cataract. Methods Totally 26 patients（26 eyes）,11 males and 15 females,were included in this study. Ages were between 21 - 48 years old,averaged at 37. 5. Preoperative visual acuity was below 0. 4 in the cataract eye and above 0. 6 in the fellow eye for all patients except that in 1 patient visual acuity was 0. 6in cataract. Pretreatment conditions included hyperopia（3 eyes）,high myopia（9 eyes,among which 1 eye received excimer laser therapy,and 3 eyes had astigmatism larger than- 1. 00 D）,diabetes mellitus（3 patients）,uveitis（3 eyes）,trauma（2 eyes）,and history of vitrectomy（1 eye）. Patients received routine examinations and IOL power calculation.Phacoemulsification was performed followed by the implantation of intraocular lens,including 3 AcrysofToric IOLs,under local anesthesia. In addition,seven patients were prescribed with contact lens for the fellow eye,and 2 patients received laser in situ keratomileusis（LASIK） in the fellow eye. Results All patients obtained improved visual acuity with varying degrees. Postoperative visual acuity of those that had no obvious predisposing causes reached 1. 2. AcrysofToric IOLs that were implanted in 3 patients remained stable axis after 6 months. Patients who have suffered severe anisometropia gained better binocular vision with contact lens wearing or excimer laser therapy on the fellow eyes. Conclusions The implantation of intraocular lens after phacoemulsification in the treatment of young and middle-aged monocular cataract patients is an effective and safe method. Indications for the surgeryshould be personalized according to patient＇s age,refraction of the fellow eye,and the demands from work and daily life. Severe anisometropia should be corrected via contact lens wearing or excimer laser therapy in the fellow eye in order to restore binocular vision and to improve the quality of life.