小切口非超声乳化白内障术中玻璃体脱出的预防和处理

Prevention and treatment of prolapsus vitreous in small-incision non-phacoemulsication cataract extraction

目的：探讨在基层医院行小切121非超声乳化白内障摘除联合人工晶状体植入术中玻璃体脱出的原因和预防以及处理办法。方法：对我院2006年10月21日～11月10日光明行动中500例手术中有41例（41只眼）玻璃体脱出的情况进行回顾性分析。结果：38只眼玻璃体脱出发生在劈核、圈套核和吸皮质时，3只眼发生于上浮核时；28只眼植入人工晶状体，其中3只眼缝襻，13只眼未植入人工晶状体（5只眼合并高度近视）；38只眼获得满意圆瞳孔，3只眼欠园；3只眼术后视力〉0．5，9只眼视力〉0．3，18只眼视力〉0．1，9只眼视力〉0．05，2只眼视力〈0．05。结论：小切121非超声乳化白内障摘除联合人工晶状体植入发生玻璃体脱出多在劈核、圈套核及吸取皮质时，玻璃体脱出经过及时恰当的处理仍然可以获得较满的效果。

Objective Discussion prevention and treatment methods of prolapsus vitreous during small-incision non-phacoemulsication cataract extraction and intraocular lens implantation in primary hospitals without anterior vitrectomy. Methods Retrospectively analyze prolapsus vitreous of 41 eyes in small-incision non-phacoemulsication cataract extraction at work of operating on 500 blind eyes during Peng-nian Bright Light Action in our hospital from October 21 to November 10, 2006. Results There were 38 cases of the prolapsus vietreous appered in the time that split core, trap core and inhale cortex;3 cases appered in the time that float up core. We implanted IOL in 28 eyes（68.3% ）and gave up IOL implantation in 13 eyes. In these prolapsus vitreous case, 38 eyes had round pupil and 3 eyes pupils were not tound. The visual acuity was 0.5 or better in 3 eyes, 9 eyes were 0.3 or better, 18 eyes exceeded 0.1,9 eyes surpassed 0.05,2 eyes didn＇t exceed 0.05. Conclusion Vitreous emerge rise often in splitting core, trapping core and inhaling cortex in small-incision non-phacoemulsioation cataract extraction and IOL implantion. Better results will be gotten after correct and timely treatment.