成人后极性白内障超声乳化吸出术疗效观察

Surgical effectiveness of phacoemulsification for adult posterior polar cataract

目的探讨成人后极性白内障超声乳化摘出联合人工晶状体植入术的手术技巧、术中术后并发症的处理方法及手术效果。方法对我院临床确诊的17例(26眼)成人后极性白内障患者行超声乳化摘出联合人工晶状体植入,观察术中后囊膜情况、术后视力、后囊膜混浊和并发症的发生情况。同时与我院同期普通白内障超声乳化术中后囊膜破裂发生率进行对比。结果 17例26眼成人后极性白内障患者术中可见后囊膜完整透明者12眼,后囊膜完整伴不同程度混浊者7眼,后囊膜中央局限性缺损者2眼,但术中未发生玻璃体溢出。术中后囊膜破裂5眼,发生率为19.23%。同期普通白内障超声乳化术中后囊破裂发生率为1.81%,二者相比差异有统计学意义(P<0.05)。成人术后视力均较术前有不同程度提高。术后9眼角膜轻度水肿,经治疗后1周内恢复透明,3眼前房纤维素样渗出,经治疗后痊愈。结论后极性白内障虽具有特殊性,后囊膜破裂发生率明显高于普通白内障。只要给予足够重视,行超声乳化摘出联合人工晶状体植入术是较好的手术方法。

Objective To investigate the surgical technique,managements of intraoperative or postoperative complications and surgical effectiveness of phacoemulsification with foldable intraocular lens（IOL） implantation for adult posterior polar cataract.Methods Phacoemulsification with IOL implantation were performed in 17 cases（26 eyes） with adult posterior polar cataract diagnosed in our hospital,the intraoperative posterior capsule,postoperative visual acuity,posterior capsule opacification and postoperative complications were observed.Meanwhile,the posterior capsule rupture rate in phacoemulsification for adult posterior polar cataract was compared with common cataract in the corresponding period in our hospital.Results The posterior capsules were intact and transparent in 12 eyes,intact with opacification in 7 eyes,and defective of central area in 2 eyes,but no vitreous prolapsed.Five eyes（19.23%） developed posterior capsule rupture;Meanwhile,the posterior capsule rupture rate in common cataract phacoemulsification was 1.81%,there was statistical difference（P0.05）.Nine eyes had the corneal edema and returned to transparence in 1 week after treatment,3 eyes had cellulose like exudation in anterior chamber and cured after treatment.Conclusion Adult posterior pole cataract has the specificity,its capsule rupture rate is higher than common cataract.However,if we pay enough attention to it,phacoemulsification with IOL implantation is still a good surgical technique.