玻璃体手术后白内障摘出术的技巧

Surgical technical in cataract surgery after pars plana vitrectomy

目的 分析进行过玻璃体手术的患者行现代白内障囊外摘出术 (ex-tracapsular cataractextraction,ECCE)的特殊性及手术技巧。方法 2 0例玻璃体切割术后患者再次入院行 ECCE,术中用前房维持器 (anterior cham berm aintainer,ACM)维持前房深度后进行手术。结果 全部患者术后眼压正常 ,未见视网膜脱离复发及脉络膜脱离 ,术后视力均有所提高。结论 这类患者无玻璃体填充 ,一旦切开前房即会出现眼内房水流出 ,眼压过低而造成眼球壁塌陷 ,使得白内障手术操作困难 ,我院采用 ACM持续灌注及自闭式切口维持眼球内压力 ,取得较好临床效果。

Objective To analysis the particularity and surgical technical of extracapsular cataract extraction (ECCE) in eyes that had previous pars plana vitrectomy (PPV). Methods We accomplished ECCE using the anterior chamber maintainer (ACM) in 20 eyes after PPV. Results For all patients the normal intraocular pressure (IOP) remained stable and the post-operation visual acuity improved, no patient occurred retinal redetachment and choroidal detachment. Conclusion For those patients who don't have vitreous tamponade sclera collapse will occur because aqueous fluid run off and the IOP is too low as soon as the eyeball is cut open, and then ECCE becomes hard. We create good clinical effect in maintaining the IOP by using ACM and the self-close incisions.