小切口白内障术中后囊膜破裂一期人工晶体植入术观察

Observation of first intraocular lens implantation about the posterior capsule rupture in small incision cataract surgeries

目的评价小切口白内障手术中后囊膜破裂的原因及处理方法。方法回顾性分析74例(86眼)糖尿病性白内障患者行小切口白内障联合人工晶体植入术,其中24例后囊膜破裂,玻璃体溢出,行前部玻璃体切割术联合人工晶体植入术。结果本组患者手术中后囊膜破裂发生率为27.9%,全部行一期后房型人工晶体植入术。其中2例囊袋内固定,8例睫状沟固定植入,14例行人工晶体双攀缝线固定法植入。随访时间1～24个月,术后视力明显提高,无严重并发症。结论后房型人工晶体睫状沟或缝线固定是小切口白内障术中后囊膜破裂一期植入人工晶体的有效方法。

Objective To investigate the reasons and treatments of the posterior capsule rupture in small incision cataract surgeries. Methods Retrospectively analyzed 86 eyes of 74 diabetic cataract patients with small incision cataract surgery, in which 24 eyes were of posterior capsular rupture, vitreous loss, and with anterior vitrectomy and intraocular lens im- plantation. Results The probabiliy of posterior capsule rupture in this group was 27.9%, and all eyes were operated by the first posterior chamber intraocular lens implantation, including 2 cases were operated by intracapsular fixation, and 8 cases were operated by ciliary sulcus implantation, and 14 cases were operated by suspensive intraocular lens implantation. Fol- low-up 1 to 24 months, and after the surgery, visual acuity were improved significantly without serious complications. Conclusion Ciliary sulcus fixation and suture fixation of posterior chamber intraocular lens are valid treatments for first in- traocular lens implantation about the posterior capsule rupture in small incision cataract surgeries.