晶状体囊破裂白内障摘出时机和二期人工晶状体植入疗效观察

The investigation on surgical of timing traumatic cataract with capsula broken and clinical effect of secondary intraocular lens implantation

目的探讨晶状体囊破裂外伤性白内障的最佳手术时机，观察二期人工晶状体植入疗效。方法对44例（44眼）合并晶状体囊破裂外伤性白内障，根据患者年龄、外伤性质、损伤范围及炎症程度，选择合适时机行白内障摘出及人工晶状体植入术。眼球破裂、穿孔伤者，首先缝合伤口；晶状体皮质溢出前房引起重度炎症反应或继发青光眼者，立即急诊手术；外伤后虹膜睫状体炎症反应重，先控制炎症，待炎症稳定后手术。44眼均在1个月内二期植入人工晶状体。结果术后随访1—3个月，矫正视力达0．05—0．08者3眼（6．82％），0．1—0．2者6眼（13．64％），0．3—0．4者14眼（31．82％），0．5—0．8者17眼（38．64％），1．0以上者2眼（4．54％）。结论选择正确的手术时机对于晶状体囊破裂白内障获得最佳视力及减少并发症至关重要。

Objective To investigate the surgical timing of traumatic cataract with capsula brokenand clinical effect of secondary intraocular lens implantation. Methods In 44 patients （44 eyes） of trau- matic cataract with capsula broken, the catarat extraction and IOL implantation were performed on different time, according to the age, type and extent of trauma, degree of inflammation and accompanying injuries. In principle, corneal wound need prompt surgical intervention. If cortex extruded into anterior chamber or secondary glaucoma occurred, the surgery was done in emergency. For severe ocular inflammation, surgical intervention was considered until inflammation was controlled. 44 eyes underwent subsequent IOL implantation in 1 month. Results Follow-up visit after operation was 1 to 3 months. Best-corrected visual acuity（ BC- VA） was 0. 05 - 0. 08 in 3 eyes （6.82%）,0.1-0.2in6 eyes （13.64%）, 0.3-0.4 in 14 eyes （31. 82% ）, 0.5 -0.8 in 17 eyes （38.64%）, better than 1.0 in 2 eyes （4.54%）. Conclusions The vision of patients with eapsula broken is improved after surgical intervention. Appropriate surgical timing is important for patients suffering traumatic cataract with eapsula broken to achieve final best-corrected visual acuity and decrease the postoperative complications.