葡萄膜炎并发白内障两种手术方法的探讨

Study on two surgical techniques in cases of secondary cataract after uveitis

目的 介绍 2种小瞳孔下行葡萄膜炎并发性白内障摘出和瞳孔成形的手术方法。方法 30例 34只葡萄膜炎严重后粘连并发性白内障的眼接受了该 2种手术。手术方法 :(1)剪除瞳孔区机化的前囊膜 ,瞳孔缘剪开 ,水分离核 ,囊袋内晶状体圈匙反转娩出晶状体核 ,人工晶状体 (IOL)植入 ;(2 )上方虹膜根部切除 ,分离并剪开上方虹膜 ,超声乳化白内障摘出 ,IOL 植入。最后缝合上方虹膜 ,人造圆形瞳孔。结果 术后 34眼瞳孔均在 3.0～3.5 m m,并保持圆形 ,均无后囊膜破裂 ,无严重并发症发生。视力均比术前有不同程度的提高。结论 葡萄膜炎并发白内障 ,在采用所介绍的 2种手术方法后能获得良好的视力和圆形瞳孔 。

Objective To introduce two surgical techniques for cataract extraction and pupil reformation under small pupil in cases of secondary cataract after uveitis .Methods Thirty four eyes of 30 patients received such kinds of operations. For the first technique, the surgical procedures included anterior capsulectomy, making radial cuts at pupillary margin ,hydrodisection and IOL implantation .For the second technique ,the surgical procedures included peripheral iridectomy, superior iris cutting, phacoemulcification ,posterior chamber implantation, iris suturing and pupil reformation.Results All of the 34 eyes had 3.0～3.5mm round pupils postoperatively. No posterior capsular rupture occurred and no severe complications were found .Visual acuity was increased in various degrees.Conclusion For secondary cataract after uveitis, good acuity and round pupil may be obtained with the two surgical techniques ,without severe complications.