玻璃体切除术后的白内障摘除及人工晶体植入术

Cataract extraction and intraocular lens implantation after vitrectomy

目的探讨玻璃体切除术后的白内障手术特点及术式选择。方法玻璃体腔液体灌注维持眼内压行白内障囊外摘除或超声乳化吸出联合人工晶体植入术。结果３７例（４０只眼）中，术后视力≥０．１者３１只眼（７７．５％），≥０．３者１２只眼（３０．０％）。术中并发症有晶体核脱位至玻璃体腔内（１只眼）、玻璃体出血（１只眼），术后并发症为虹膜红变（１只眼）、人工晶体夹持（１只眼）。结论玻璃体切除术后的白内障手术必须采取克服低眼压的措施，玻璃体腔液体灌注是一种比较理想的方法；对于晶体核硬化明显的患者，白内障囊外摘除较超声乳化吸出更为适用。

Objective To study the characteristics of cataract extraction and surgical techniques in cases following vitrectomy. Methods Extra capsular extraction/phacoemulsification of cataract and intra ocular lens implantation were performed under vitreous irrigation. Results Of 37 cases (40 eyes), 31 eyes (77.5%) had obtained post operative visual acuity ≥ 0.1, 12 eyes (30.0%) ≥0.3. The complications included nuclear dislocation into vitreous cavity (1 eye) and vitreous hemorrhage (1 eye) in the operation, and rubeosis iridis (1 eye) and pupillary capture (1 eye) after the operation. Conclusion Anti hypotony must be emphasized in the operation of cataract extraction after vitrectomy, and the vitreous irrigation is a good way against hypotony, extra capsular extraction is more suitable than phacoemulsification in cases with hard nucleus.