玻璃体切割术后白内障手术

Cataract extraction in vitrectomised eyes

目的探讨玻璃体切割术后的白内障选择不同的手术方法治疗时的临床特征及其并发症和视力预后。方法回顾分析48例48眼玻璃体切割术后的白内障病例，其中32例施行超声乳化术，16例行囊外摘除术，分析两组术中发现、术后早期和晚期的并发症和术后视力。结果两组术中均观察到前房过深且不稳定、后囊易破裂、瞳孔变小等并发症，术后两组早期并发症主要是角膜水肿，后期是后囊混浊，两组术中术后并发症差异无统计学意义，两组术后视力均比术前明显提高。结论玻璃体切割术后特殊类型白内障手术难度大，选择合适的手术方式可以减少并发症，做到安全高效。

Objective To discuss the clinical characteristics of cataract extraction by different ways in eyes that had undergone parsplana vitrectomy and to determine the complications and visual out- comes. Methods In this retrospectively study, there were 48 eyes （48 cases） of cataracts which had been done previousely with parsplana vitrectomy. Phaeoemusification were performed in 32 eyes out of them. The others were operated on with extracapsular cataract extraction. The data of two groups including intraoperative observations, ealy and late postoperative complications, final visual acuity were analysed. Results Intraoperative complications including excessive deep and unstable anterior chamber, the weakened posterior capsular and small pupil were observed in both groups. The notable early postoperative complications was corneal edema, the late was posterior capsular opacification among the groups. The difference in intraoperative and postoperative complications between the two groups was not statistically significant. The final visual acuity were better than preoperative ones in two groups. Conclusions The special type of cataracts in vitrectomised eyes present a special challenge. It is a safe and effective way to choose proper operation methods for extremely reducing the complications.