基层医院小切口白内障手术常见并发症及处理

Common complications and management of small incision cataract extraction in primary hospitals

目的: 探讨小切口白内障摘除联合人工晶状体植入术在白内障治疗中的安全性,对术中术后并发症进行分析并提出相应的处理措施。方法: 对1232眼白内障患者进行小切口白内障囊外摘除及人工晶状体植入术,回顾其术后并发症的情况。结果: 术中虹膜脱出19眼(1.54%),虹膜根部离断4眼(0.32%),晶状体后囊膜破裂62眼(5.03%),后弹力层脱离4眼(0.32%)。术后角膜内皮水肿56眼(4.54%),暂时性高眼压62眼(5.03%),急性眼内炎2眼(0.16%),葡萄膜炎反应42眼(3.41%),前房出血5眼(0.41%),视网膜脱离1眼,皮质残留28眼(2.27%)。结论: 小切口白内障囊外摘除联合人工晶状体植入术是一种安全、简便、有效的手术方法。但因技术不熟练和经验不足可引起各种并发症,为获得满意的手术结果,应熟练掌握手术技巧,妥善处理并发症。

·AIM： To discuss the security of small incision cataract extraction and intraocular lens implantation in cataract treatment, and to analyze intraoperative and postoperative complications and promote corresponding management.·METHODS： The surgery, extracapsular cataract extraction with small incision and intraocular lens implantation, was performed on 1232 eyes with cataract. And complications were reviewed. ·RESULTS： In the surgery： there were 19 eyes （ 1.54% ） with irisprolapse, 4 eyes （0.32%） with iridodialysis, 62 eyes C5.03%） with ruptured posterior lens capsule, 4 eyes （0.32%） with detachment of post elastic layer. After the surgery： there were 56 eyes （4. 54%） with corneal endothelial edema, 62 eyes （5. 03%） with temporary intraocular hypertension, 2 eyes C0. 16%） with acute endophthalmitis, 42 eyes （3.41%） with uveitic reaction, 5 eyes （0. 41%） with hyphema, 1 eye with retinal detachment, 28 eyes C2.27%） with residual cortex.·CONCLUSION： Extracapsular cataract extraction with small incision and intraocular lens implantation is a safe, simple, and effective operation. However, various complications may occur due to nonproficiency and inadequate experience. Consequently, in order to achieve approving surgical outcome, operative skills should be mastered proficiently, and complications should be managed appropriately.