白内障超声乳化吸出联合人工晶状体植入术高危因素临床分析

Risk factors of phacoemulsification with intraocular lens implantation

目的总结白内障超声乳化吸出联合人工晶状体植入手术的高危因素和术中、术后并发症。方法对912例(1052眼)行白内障超声乳化吸出联合人工晶状体植入术的患者总结术前增加手术难度、影响术后视力恢复的高危因素,并统计患者术中、术后并发症。结果术前高危因素有28种,主要包括高血压423例(46.4%),糖尿病351例(38.5%),哮喘28例(3.1%),驼背37例(4.1%),高度近视63眼(6.0%),抗青光眼手术史48眼(4.6%),玻璃体切割术史74眼(7.0%),角膜老年环367眼(34.9%),虹膜粘连64眼(6.1%),膨胀期白内障87眼(8.3%)等。术中并发症包括前囊膜破裂6眼(0.6%)、后囊膜破裂13眼(1.2%)、后弹力层脱离1眼(0.1%)、虹膜损伤14眼(1.3%)、晶状体核坠入玻璃体内1眼(0.1%);术后并发症包括角膜内皮水肿57眼(5.4%)、一过性高眼压83眼(7.9%)、黄斑水肿6眼(0.6%)、人工晶状体移位1眼(0.1%)、虹膜无张力1眼(0.1%)。结论全面了解术前存在于患者影响手术的高危因素,做好术前、术中充分准备,有助于减少手术并发症。

Objeetive To summarize the risk factors of phacoemulsification cat- aract surgery with intraocular lens implantation, and analyze the relationship between complications and risk factors. Methods The risk factors that increasing the difficulty of phacoemulsification cataract surgery with intraocular lens implantation and affecting visual acuity in 912 cases（ 1052 eyes） were summarized. Intra-operative and post-opera- tive complications were counted. Results A total of 28 kinds of pre-operative risk factors affecting the surgery were counted, including hypertension in 423 cases （46.4%） ,diabetes in 315 cases（38.5% ） ,asthma in 28 cases（3.1% ） ,humpbacked in 37 cases（4.1% ） ,high myopia in 63 eyes（6.0% ） ,glaucoma surgery in 48 eyes（4.6% ） ,vit- rectomy in 74 eyes（7.0% ） ,cornea arcus senilis in 367 eyes（34.9% ） ,synechia of iris in 64 eyes（ 6.1% ） ,intumescent cataracts in 87 eyes （8.3%）, et al. Intra-operative compli- cations included anterior capsular rupture in 6 eyes （0.6%）, posterior capsular rupture in 13 eyes（ 1.2% ） ,Descemet＇ s membrane detachment in 1 eyes（0.1% ） ,iris damage in 14 eyes （1.3%） ,drop of lens fragments into vitreous in 1 eye （0.1%）. Post-operative complications included corneal endothelial edema in 57 eyes （5.4%）, temporary intraoc- ular hypertension in 83 eyes（7.9% ） ,macular edema in 6 eyes（0.6% ） ,intraocular lens shifting in 1 eye （0.1%） ,pupillary dilatation in 1 eye （0.1% ）. Conclusion Getting the whole picture of risk factors before surgery and doing preparation for cataract sur- gery carefully can reduce intra-operative and post-operative complications.