白内障超声乳化人工晶状体植入术965例临床分析

Clinical analysis of phacoemulsification in 965 cases

目的:探讨白内障超声乳化人工晶状体植入术的临床疗效,分析手术并发症及其处理。方法:对965例1024眼白内障患者行透明角膜或巩膜隧道切口白内障超声乳化人工晶状体植入术,总结分析术后低视力原因及手术并发症。结果:顺利完成超声乳化术998眼(97.46%),26眼改为ECCE+IOL术;术后最佳矫正视力(术后1mo):视力<0.3者141眼(13.77%),视力0.3～0.8者730眼(71.29%),视力≥1.0者153眼(14.94%);术中后囊膜破裂41眼(4.00%),撕囊失败16眼(1.56%)。虹膜损伤5眼(0.49%),核坠入玻璃体腔者2眼(0.20%)。术后角膜水肿98眼(9.57%),一过性高眼压31眼(3.03%),人工晶状体坠入玻璃体腔者1眼(0.10%),眼内炎4眼(0.39%),眼球萎缩2眼(0.20%)。结论:白内障超声乳化人工晶状体植入术具有创伤小、恢复快,术后视力满意等优点,但是了解手术并发症原因,减少和避免并发症的发生以及正确处理并发症,是手术成功的保障。

AIM. To analyze the clinical curative effect and operation complications in the process of extracapsular extraction of cataract by phacoemulsification. METHODS： Nine hundred and sixty-five cases （1024 eyes） of cataract were treated by corneal tunnel incision or sclera tunnel incision phacoemulsification cataract extraction,and analysed the reason of low vision and the operation complications. RESULTS： Phacoemulsitlcation was performed succcssfially on 998 eyes （97. 46%） , and 26 eyes were changed to extracapsular cataract extraction combined with intraocular lens implantation. 141 eyes （13.77%） attained corrected vision under 0.3- 730 eyes （71. 29%） attained corrected vision of 0.3 to 0.8 ; 153 eyes（14.94% ） attained corrected vision of 1.0 or better after operation in four week. During the operations there were capsular rupture in 41 eyes（4.00%）, defeated capsulorhexis in 16 eyes（1.56%）, damage of iris in 5 eyes（0.49%）, fallen nucleus in vitreoas cavity in 2 eyes （0.20%）, corneal endothelial edema 98 eyes （9.57%）, intraocular hypertension 31 eyes （3. 03% ）, artificial lens fallen nucleus in vitreoas cavity in 1 eye （0. 10%）, entophthalmia in 4 eyes （0.39%） and atrophy of eyeball in 2 eyes（0.20%）.CONCLUSlON; The extraction of cataract by phacoem- ulsification and embedding of artificial crystal may have less tissue damage, and vision recover quickly. Though it is an effective method, to understand the reason for operation complication,to reduce the operation complication and to avoid it can ensure the success of operation.