严重虹膜后粘连小瞳孔白内障手术的临床观察

目的探讨严重虹膜后粘连小瞳孔白内障手术方法。方法采用白内障超声乳化吸除术联合人工晶体植入术，并与现代囊外摘除及人工晶体植入手术患者进行比较分析。结果A、B两组术后3个月瞳孔状况：直径2—3．0mm，平均2．5mm，园形或近似园形，居中，无虹膜萎缩。视力：术后视力均有不同程度提高，0．1～0．5者15例（15只眼），0．6～0．8者17例（18只眼），0．9～1．0者27例（29只眼），1尺指数-0．05者19例（19只眼），此19例患者术后查眼底均见黄斑及后极部存在不同程度病变或玻璃体混浊。比较发现，两组术后3个月瞳孔状况差异无统计学意义（P〉0．05）。但是与B组相比，A组的平均手术时间、角膜内皮细胞损失率、术中并发症发生率均明显低于B组，差异有统计学意义（P〈0．05）。结论采用白内障超声乳化人工晶体植入的手术时间短，损伤小、愈合快，可以保留完整的功能滤过区，从而降低了术中、术后并发症，能够取得更好的临床疗效。

Objective To evaluate the surgical treatment for the iris posterior synechia small pupil cataract. Methods Phacoemulsifieation cataract surgery and intraocular lens implantation, and modern ECCE surgery were comparatively analyzed. Results In A, B groups, 3 months after the pupil status：2 - 3.0mm in diameter on average 2. 5ram, Park - shaped or similar shaped park, center, without iris atrophy; vision：visual acuity increased to varying degrees, 0. 1 - 0. 5 in 15 cases of 15 eyes, 0. 6 - 0. 8 were 17 cases of 18 eyes, 0. 9 to 1.0 were 27 cases of 29 eyes, a foot index of - 0. 05, 19 cases 19 eyes, the 19 patients were seen after check - related macular and retinal posterior pole with various degrees of lesion or vitreous opacity. Comparison, the two groups 3 months later, the situation was no significant difference between the pupil （ P 〉 0. 05 ）. However, when compared with the B group, the average operative time, corneal endothelial cell loss rate, the incidence of intraoperative complications of A group were significantly lower than those in B group （ P 〈 0. 05 ）. Conclusion Phacoemulsification and intraocular lens implantation surgery has a shorter time, less damage, with more quickly in healing, the full function of filtration area can be preserved, thus reducing intraoperative and postoperative complications.