自闭式隧道切口白内障摘除术并发症分析与处理

Analysis and treatment of complications of cataract extraction using interoperative and postoperative scleral tunnel incision in 712 eyes

目的:总结分析自闭式隧道小切口白内障摘除术术中术后并发症及处理。方法:统计本院用隧道切口行白内障摘除608例(712眼),对出现并发症124眼进行分类分析。结果:用以上方法手术者出现并发症124眼(17.4%),以次序排列为角膜内皮水肿88眼(12.3%);后囊破裂25眼(3.5%);继发青光眼6眼(0.8%);瞳孔括约肌麻痹2眼,晶状体襻脱位2眼,前房出血2眼,虹膜脱出2眼,各占0.28%。经治疗后1例角膜失代偿外院角膜移植,其余恢复良好。结论:自闭式隧道切口白内障摘除人工晶状体植入术出现的并发症较轻且能有效预防和处理,随着手术熟练程度的提高并发症亦将逐步减少,未发生晶状体核下沉于玻璃体内等严重并发症,对于基层中小医院可作为白内障手术的首选术式。

AIM: To analyze the complications of cataract extraction using interoperative and postoperative scleral tunnel incision as well as the treatments.· METHODS: All statistics on cataract extraction using scleral tunnel incision came from our hospital from April 1998 to March 2002. We classified and analyzed 124 eyes with complications among 712 eyes of 608 aptients.· RESULTS: Complications appeared in 124 eyes (17.4%), including coneal edema in 88 eyes (12.3%), posterior capsule rupture in 25 eyes (3.5%), secondary glaucoma in 6 eyes (0.8%), paralysis of sphincter pupillae muscle, IOL dislocation, hyphema and iris prolapse in 2 eyes (0.3%) respectively. All eyes restored well after treatment except 1 eye which was treated by coneal transplantation because of coneal decompensatory.· CONCLUSION: The complications of cataract extraction using scleral tunnel incision are not serious. It can be prevented and cured effectively and lessened with the progress of operators' proficience degree. Thus this operation can be used widely as the first choice for cataract in primary hospitals.