农村白内障患者人工晶状体植入术后低视力病因分析

Causual analysis of low vision after intraocular len implantation in rural cataract patients

目的分析农村白内障患者小切口非超声乳化人工晶状体植入术后低视力发生的原因及防治方法。方法对556例(589眼)农村白内障患者行小切口非超声乳化人工晶状体植入术,于术后1d、1周、1月、3月分别测定手术眼的裸眼视力,<0.5归为低视力者,对低视力患者进行病因分析。结果术后1d低视力者235眼(39.9%),其主要原因为手术并发症共112眼(47.6%);随着术后时间的延长,低视力人数逐渐减少,至术后3月低视力者120眼(20.3%),而其原因为屈光不正45眼(37.5%)和眼底病37眼(30.8%)。结论人工晶状体计算误差造成的屈光不正、手术源性散光及眼底病变是造成小切口非超声乳化人工晶状体植入术后低视力的主要原因,低视力的发生与病例的选择及技术操作有关。

Objective To analyze the causes and the countermeasure of low vision after small incision non-phacoemulsification cataract extraction and intraocular len（IOL） implantation in rural cataract patients. Methods Five hundreds and fifty-six cases （589 eyes） were performed small incision non-phacoemulsification cataract extraction and IOL implantation. At post-operation 1 day, lweek, lmonth, 3months, naked visual acuities were measured. Naked visual acuity less than 0.5 were considered as low vision,and the causes of low vision were analyzed. Re, suits At post-operation 1 day, low vision eyes occurred in 235 cases （39.9%）, the main cause of which lies in operative complications（ 112 cases, 47.6% ）. Afterwards low vision eyes were gradually decreased. At post-operation 3 months, low vision eyes occurred in 120 cases （20.3%）,the main cause of which were refraction error （37.5%） and fundus diseases （30.8%）. Conclusion The main causes of low vision after small incision non-phacoemulsification cataract extraction and IOL implantation are refraction error because of IOL calculation error, operative astigmatism and fundus diseases. The occurrence of low vision is relevant to cases selecting and technical manipulation.