白内障伴浅前房患者行超声乳化术的手术技巧及安全性探讨

目的探讨白内障伴浅前房患者行超声乳化术的手术技巧及安全性。方法选择2018-01~2019-01于北海市第二人民医院眼科接受超声乳化术治疗的白内障伴浅前房患者46例(46眼)。比较患者术前、术后的视力、眼压、中央前房深度(CACD)、房角开放距离(AOD)、角膜内皮细胞密度,分析术后并发症发生情况。结果患者术前平均视力为(0.28±0.16),术后上升至(0.62±0.22),差异有统计学意义(t=8.688,P=0.000)。与术前比较,患者术后眼压降低,CACD增加,差异有统计学意义(P<0.05)。在治疗后,术眼“3点”、“6点”、“9点”和“12点”方位的AOD500均较术前显著增加(P<0.05)。术中发生虹膜损伤3例(6.52%),悬韧带部分断裂1例(2.17%),仍安全顺利植入人工晶体。术后发生角膜水肿16例(34.78%),术后1个月均恢复。未发生后囊破裂和角膜失代偿等较严重并发症。结论超声乳化手术能有效改善白内障伴浅前房患者眼前节拥挤情况,具有较好的疗效和安全性。术前评估以及准备、手术中技巧的合理应用是保证手术成功的关键。

Surgical techniques and safety of phacoemulsification for cataract patients with shallow anterior chamber

Objective To investigate the surgical techniques and safety of phacoemulsification for cataract patients with shallow anterior chamber.Methods Forty-six cataract patients(46 eyes)with shallow anterior chamber who received treatment of phacoemulsification were selected in the Department of Ophthalmology of the Second People′s Hospital of Beihai City from January 2018 to January 2019.The patients′preoperative and postoperative visual acuity,intraocular pressure,central anterior chamber depth(CACD),angle opening distance(AOD),and corneal endothelial cell density were compared.The incidence of postoperative complications was analyzed.Results The preoperative mean visual acuity of the patients was(0.28±0.16),and their postoperative mean visual acuity improved to(0.62±0.22),with a significant difference(t=8.688,P=0.000).Compared with those before operation,the intraocular pressure was reduced and CACD was increased in the patients,and the differences were statistically significant(P<0.05).After treatment,the AOD500 values of the“3 o′clock”,“6 o′clock”,“9 o′clock”and“12 o′clock”positions of the operated eyes were significantly increased compared with those before operation(P<0.05).The intraoperative iris injury occurred in 3 cases(6.52%),and the partial rupture of suspensory ligament in 1 case(2.17%),but the intraocular lens were still implanted safely and successfully.The postoperative corneal edema occurred in 16 cases(34.78%)and the patients recovered one month after operation.No severe complications such as posterior capsule rupture and corneal decompensation occurred.Conclusion Phacoemulsification can effectively improve the crowding of the anterior segment of cataract patients with shallow anterior chamber,and has good efficacy and safety.The key to the success of the operation is the preoperative evaluation and preparation,and the reasonable application of surgical techniques during the operation.