摘要
目的分析玻璃体切除术后硅油填充眼并发性白内障的特点、形成的原因及超声乳化术的效果。方法回顾分析我院硅油填充眼并发性白内障接受晶状体超声乳化术47例（51眼）。其中男28例（28眼），女19例（23眼）。年龄22～75岁，平均（55．45±11．37）岁。硅油填充眼原发病是：孔源性视网膜脱离11例（11眼），高度近视黄斑孔3例（3眼），增生性糖尿病视网膜病变27例（31眼），视网膜静脉阻塞4例（4眼），眼球穿孔外伤2例（2眼）。白内障术前视力为光感～0．25。术前眼压13．0～41．0mmHg，平均（16,87±5．29）mmHg（1mmHg=0．133kPa）。术前角膜内皮细胞密度为845～3448／mm^2，平均（2632．8±402．9）／mm^2。术后随访3～6个月，平均（4．71±1．12）个月。结果硅油填充眼白内障以核浑浊为主，晶状体后皮质很少并与后囊紧密粘连。术后视力为光感～0．6，其中术后视力提高47眼（92．、16％），不变3眼，下降1眼。术后眼压11．0～24．0mmHg，平均（14．82±2．56）mmHg，较术前降低（P=0．005）。术后角膜内皮细胞密度608-2850／mm^2，平均为（1926．89±449．91）／mm^2，较术前降低（P=0．000）。术中术后并发症主要包括：术中后囊破裂1眼，术后一过性高眼压5眼，所有眼均出现不同程度的角膜水肿，前房不同程度炎性反应29眼，前房红细胞漂浮1眼，瞳孔区纤维素性渗出1眼。结论硅油填充眼并发性白内障以晶状体核浑浊为主，后囊下有少量透明皮质，这些皮质与后囊紧密粘连。手术中可加大负压并降低超声能量，注意保护晶状体后囊。该手术安全有效。
Objective To analyze the characteristics of complicated cataract of silicone oil tamponade eyes after pars plana vitrectomy, and to evaluate the effects of phacoemulsification and its relative factors. Methods Data of 51 eyes of 47 patients who underwent the treatment of phacoemusification for complicated cataract after silicone oil tamponade were analyzed. Twenty-eight patients were males （28 eyes）, and 19 were females （23 eyes）. The average age was （55.45 ± 11.37 ） years old with a range from 22 to 75 years old. The protopathy of all patients with silicon oil tamponade eyes included rhegmatogenous retinal detachment in 11 patients （11 eyes）, macular hole induced by high myopia in 3 patients （3 eyes）, PDR in 27 patients （31 eyes）, retinal vein occlusion in 4 patients （4 eyes）, and penetrating ocular injury in 2 patients （2 eyes）. The preoperative best corrected visual acuity （BCVA） ranged from light perception to 0.25. The preoperative intraocular pressure （IOP） was （ 16.87 ± 5.29） mmHg （ 13.0 ± 41.0 mmHg）. The corneal endothelial cell counts was （2632.8 ± 402.9）/mm^2 （845 ± 3448/mm^2 ）. The follow-up was （4.71 ± 1.12） months with a range from 3 to 6 months. Results The lens in silicon oil tamponade eyes was characterized by nuclear opacity with little posterior cortex adhered tightly to the posterior capsule. The postoperative BCVA ranged from light perception to 0.6. BCVA increased in 47 eyes, remained stable in 3 eyes, and decreased in 1 eye. The postoperative IOP was （ 14.82 ±2.56） mmHg with a range from 11.0 to 24.0 mmHg （1 mmHg =0. 133 kPa）, and decreased compared with preoperative one （P 〈0.05）. Thepostoperative corneal endothelial cell counts was （ 1926. 89 ± 449. 91 ）/mm^2 （608 - 2850/mm^2 ）, and decreased compared with preoperative one （ P 〈 0.05 ）. The intraoperafive and postoperative complications mainly included posterior capsule rupture （ 1 eye）, temporary IOP elevation （ 5 eyes）, various degrees
出处
《中华眼外伤职业眼病杂志》
2015年第4期288-291,共4页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
