硅油填充并发白内障行超声乳化联合硅油取出及人工晶状体植入术观察

Clinical observation of silicone oil removal combined with phacoemulcification and foldable intraocular lens implantation through clear cornea incision

目的评价硅油填充合并白内障眼经透明角膜切15行白内障超声乳化，联合经瞳孔硅油取出及折叠人工晶状体植入的临床效果。方法选择硅油填充术后合并白内障患者27只眼，手术方法为经透明角膜切口行白内障超声乳化，然后做3mm大小的晶状体后囊切开，通过前房灌注，由后囊切开处进行硅油取出，将折叠晶状体植入囊袋内或者睫状沟。评价手术时间、术后反应以及视力恢复效果。结果手术时间基本控制在20分钟以内，大部分病例折叠人工晶状体植入囊袋内。术后未见视网膜脱离复发、IOL脱位和其他严重并发症，部分病例有不同程度的角膜水肿，患者无明显刺激症状。结论经透明角膜切15行白内障超声乳化联合经瞳孔区硅油取出并植入折叠人工晶状体，这种方法与经巩膜切15的方法相比，不但减少了手术的时间，而且从理论上也较少了术后并发症和患者的刺激症状，是一种安全高效的硅油取出联合白内障手术方式。

Objective To evaluate cataract phacoemulcification combined with planned posterior capsulotomy to removal of silicone oil and fordable intraocular lens （IOL） implantation in patients after pars plana vitrectomy. Methods A prospective, 27 cases of patients underwent the combined surgical for cataract and silicone oil removal with posterior chamber fordable IOL implantation, who had served as intraocular silicone oil tamponade for various reasons. Main outcome measurements included duration of surgery, postoperative reaction and visual rehabilitation. Results Durations of surgeries were less than 20 rain, and most of IOL were implanted into the capsular bag. There was no case of retinal redetachment, IOL dislocation and serious postoperative complications. Some cases had slightly cornea edema, and most cases had no obviously irritating symptoms. Conclusions Silicone oil removal can be combined with cataract phacoemulcification and placement of a fordable IOL through clear cornea incision. In the view of a decreased frequency of postoperative complications and shorter duration of surgery and visual rehabilitation, transpupillary drainage of silicone oil through a planned posterior capsulotomy compares favorably with removal of silicone oil through pars plana sclerotomies.