老年白内障超声乳化术后早期低视力原因分析

Reasons of low vision after phacomulsification in senile cataract patients

目的探讨白内障超声乳化术后低视力的主要原因。方法回顾性分析2009-05～2010-05在我院行白内障手术的847眼术后1周视力低于0.3的118眼的眼部情况。118例患者中男56眼,女62眼,年龄60-92岁,平均72.6岁,术前均常规进行视力、裂隙灯、眼压、角膜曲率、眼A/B超及角膜内皮细胞计数检查,按SRK-T公式计算人工晶体度数,手术经巩膜隧道切口进入,环形撕囊,拦截劈核法行超声乳化术完成手术,术中无严重并发症,术后1周,1月及3月时复查眼部及视力情况,分析术后短期内即1周时视力恢复不佳的原因。结果对术后视力低于0.3的118例患者进行分析,其原因主要有:术中出现轻微并发症的有7眼,占5.93%;术后出现并发症的有7眼,占5.93%;术前存在眼底疾病的有104眼,占88.14%,术后发现眼底疾病的89眼,占75.42%。结论手术眼的原有眼部疾病,特别是眼底疾病,是老年性白内障超声乳化术后短期内低视力的主要原因。

Objective To explore the main factors of low vision after phacomulsification in senile cataract patients.Methods Phacomulsifications were performed in 847 eyes from May 2009 to May 2010.Among 847 patients,the clinical data of 118 eyes of 118 patients with best corrected visual acuity less than 0.3 at week 1 after surgery were analyzed.The 118 patients,56 male and 62 female,aged 60 to 92 years and averaged 72.6 years old.The visual acuity,slit lamp,intraocular pressure,corneal curvature,ocular A/B ultrasound and corneal endothelial cell counts were examined before surgery.Degrees of IOL were calculated by SRK-T formula.Phacomulsification was performed through scleral tunnel incision,circular capsulorhexis and block chop,and no serious complications happened during surgery.Eye and vision conditions were examined at week 1,months 1 and 3 after surgery.The reasons of poor visual acuity at week 1 after surgery were analyzed.Results Seven eyes（5.93%）had the minor intraoperative complication,and seven eyes（5.93%）had postoperative complication.Of 118 eyes,104 eyes（88.14%）had intrinsic eye disease before surgery,and 89 eyes（75.42%）had retinopathy after surgery.Conclusion Intrinsic eye disease,especially the retinopathy,is the main factor of low vision after phacomulsification in senile cataract patients.