白内障超声乳化吸出术后缺血性眼病的临床研究

Clinical analysis of ischemic ophthalmopathy after cataract phacoemulsification

目的探讨白内障超声乳化吸出术后发生缺血性眼病原因及治疗。方法回顾性分析3000例不同类型的白内障及人工晶状体植入的患者,行白内障超声乳化吸出术后共13例患者发生缺血性眼病。缺血性视神经病变8例,包括年龄相关性白内障7例,晶状体脱位1例;视网膜中央动脉阻塞5例,包括年龄相关性白内障1例,先天性白内障2例,外伤性白内障2例。患者分别行眼底、视野、眼底血管造影检查确诊后,予以扩张血管、营养神经及对症治疗。结果 8例缺血性视神经病变患者治疗后有6例视力均有不同程度的提高,5例视网膜中央动脉阻塞患者治疗后2例视力提高,3例视力未恢复。结论由白内障超声乳化手术引起的缺血性眼病,主要与患者本身存有血管性疾病和手术过程中引起视神经缺血、缺氧有关;如及早发现,尽早治疗,视力可有不同程度的提高。

Objective To investigate the cause and treatment for ischemic ophthalmopathy after cataract phacoemulsification.Methods A total of 3000 patients with cataract underwent phacoemulsification were retrospectively analyzed,and 13 patients with ischemic ophthalmopathy.The ischemic optic neuropathy（ION） were in 8 cases,7 cases occurred in age related cataract,1cases occurred in the dislocation of lens;The central retinal artery occlusion（CRAO） were occurred in 5 cases,1 cases of age-related cataract,2 cases of congenital cataract 2 cases of traumatic cataract.The patients were diagnosed with fundus,visual field and fundus fluorescein angiography respectively,and then were treated with dilation of blood vessels,nutrition nerves and symptomatic treatment.Results The visual acuity in 6 cases with ION after the treatment were improved in different degrees;The visual acuity in 2 cases with CRAO after treatment were improved,3 cases was not recovered.Conclusion Ischemic ophthalmopathy caused by phacoemulsification cataract surgery may be related to the main vascular disease or optic nerve ischemia and hypoxia during operation,and with early detection and treatment,visual acuity can be improved to some extent.