角巩膜穿孔伤伴外伤性白内障手术时机的临床研究

目的:探讨角巩膜穿孔伤伴外伤性白内障人工晶状体植入时机和初步临床疗效观察。方法:我院2000-01/2005-02共对60例(60眼)角巩膜穿孔伤合并外伤性白内障(除晶状体皮质大量进入前房者)患者进行研究,随机分成3组每组20眼。A组行角巩膜伤口修补同时行白内障囊外摘除联合人工晶状体植入;B组行角巩膜伤口修补白内障囊外摘除,3～10d内行人工晶状体植入;C组行角巩膜伤口修补后,3～10d内行白内障囊外摘除联合人工晶状体植入。随访6～18mo,结果均经统计学处理。结果:术后3组在随访期内均能获得满意的视力,术后视力较术前明显提高(3组P值均<0.05),3组均未见严重术中并发症,人工晶状体植入术后角膜水肿及虹膜炎症反应并发症A组高于B、C组,差别有统计学意义。结论:对于角巩膜穿孔伤伴外伤性白内障的患者,早期(3～10d)行人工晶状体植入是比较安全有效的。

Clinical research on the operation time of traumatic cataract caused by corneoscleral penetration injury

AIM:To discuss the operation time and clinical effects of intraocular lens(IOL)implantation for traumatic cataract caused by corneoscleral penetration injury.METHODS:A randomized comparison study on 60 cases(60 eyes)with traumatic cataract caused by perforating corneoscleral injuries were conducted.Sixty cases(60 eyes)were randomly divided into three groups(20 eyes in each group).After corneoscleral wound was repaired,cataract extraction with intraocular lens implantation was performed in group A.After corneoscleral wound was repaired and cataract extraction,intraocular lens implantation were performed within 3 to 10 days in group B.In group C,after corneoscleral wound was repaired,cataract extraction with intraocular lens implantation was performed within 3 to 10 days.The follow-up was for 6-l8 months.The preliminary clinical results of three groups were compared by statistical analysis.RESULTS:The good postoperative visual acuity in three groups were obtained postoperatively compared with preoperatively(All P<0.05).No sever intra-operative complications happened in three groups.The severest postoperative inflammatory response was higher in group A than that in group B and C(P<0.05).CONCLUSION:The surgery of the traumatic cataract caused by corneoscleral perforation requires correct operative timing and proper management.The early operation of intraocular lens implantation within 3 to 10 days is safe and effective.