粘连性小瞳孔白内障手术的临床体会

The experience of the surgery for cataract with adhesive small pupil

目的探讨粘连性小瞳孔白内障人工晶状体植入术的手术方法和效果。方法32例（38眼）瞳孔不能散大的白内障分别采用手法小切口非超声乳化白内障摘出人工晶状体植入术（22例，26眼）和超声乳化吸出人丁晶状体植入术（10例，12眼）。术后观察6～18个月，平均9．5月。结果术后视力均较术前明显提高，≤O．04者1眼（2．63％），0．05～0．25者12眼（31．58％），0．3～0．8者14眼（36．84％），≥1．0者11眼（28．95％）。术后瞳孔形状呈圆形者17眼，近圆形者21眼。瞳孔直径较术前扩大。结论小瞳孔白内障人工晶状体植入术手术较为复杂，病例筛选、手术方式的选择、手术时机以及并发症的处理等是手术成功的关键因素。

Objective To evaluate the cataract extraction and IOL implantation for the cataract with adhesive small pupil. Methods In 38 eyes of 32 cases with adhesive small pupill cataract, small incision non phacoemulsification with IOL implantation was performed on 26 eyes of 22 cases, and phacoemulsification with IOL implantation was performed on 12 eyes of 10 cases. The followed up time was 6 - 18 months, meanly 9.5 months. Results The postoperative visual acuities were evidently increase, ≤ 0.04 in one eye （2.63%）, 0.05 -0.25 in 12 eyes （31.58%） , 0.3 0.8 in l4 eyes （36.84%）, 21.0 in 11 eyes （28.95%）. The pupil were all return to round （ 17 eyes） or similar round （ 21 eyes）. The size of the pupil was larger. Conclusion The cataract surgery through a small pupil is more complicated. The key factors for successful surgery were case screening, surgery method choosing, sugery opportunity, and complications correcting.