基层医院白内障超声乳化术后角膜并发症的处理和预防

Thepreventionandtreatmentofcornealcomplicationsaftercataractextractionbyphacoemulsificationinprimaryhospitals

目的探讨基层医院白内障超声乳化吸出术（ＰＥ）角膜并发症的处理及预防措施。方法观察１９６眼超声乳化术后切口、角膜内皮、后弹力层、基质层等的并发症，分析其原因并讨论处理和预防措施。结果术后病例５５．１０％内皮线状混浊，８．１６％内皮点状、小片状混浊，基质弥漫性水肿占１８．３７％，５眼内皮失代偿。降眼压药物、激素和细胞营养剂应用可减轻并发症。结论并发症发生的主要原因与超声乳化本身潜在的四大损害因素、病例选择不当、操作不当、术中失误有关。基层医院针对原因采取相应措施，尤其注重临床选择病例，可避免或减少角膜并发症。

ObjectiveTodiscusstheonset,preventionandtreatmentofcornealcomplicationsaftercataractextractionbyphacoemulsification(PE).MethodsIn196eyesthatunderwentopticphacoemulsification,theeffectsoftheoperationonthecornealendothelium,cornealposteriorelasticlayer,cornealpropriaandincisionwerestudied.Results55.10%postoperativecomplicationswereendotheliallinearcloudiness,8.16%wereendothelialpunctateandalopeciacloudiness,18.37%stromaldiffuseedema,5%endothelialdecompensation.Reducingtheintraocularpressureandusingsteroidsandcytotrophycouldrelievethecomplications.ConclusionThefourlatentdamagingfactorsofphacoemulsificationarethemaincausesforthecomplications,inadditiontotheimproperchoiceofcasesandincorrectoperation.Inordertoavoidandreducecornealcomplications,thehospitalsshouldtakeprimary,basicmeasuresandpayattentionespeciallytothechoiceofcases.