摩洛哥光明行203例白内障的特点及手术疗效观察

Observation on the efficacy and characteristic of 203 cataract patients in Brightness Action, Morocco

目的 观察摩洛哥光明行203例白内障的特点及手术疗效.方法 2016年10月8日至10月11日中国非洲光明行动专家组于摩洛哥对203例（203眼）白内障行超声乳化联合人工晶状体植入术.分析患者晶状体浑浊特点,术后视力及并发症分析.结果 术后随访1-3个月,术后1周视力〈0.05者7眼（3.4％）,0.05 -0.25者30眼（14.8％）,0.3 -0.5者123眼（60.1％）,≥0.6者43眼（21.2％）.脱残率81.2％,脱盲率96.55％.术中并发症：29眼出现假性囊膜剥脱综合征,其中16眼行术中虹膜括约肌放射状剪开.后囊破裂者6眼,其中2眼行前段玻切后植入三片式人工晶状体,1眼改为囊外手术未植入人工晶状体;4眼高度近视眼因无该度数人工晶状体而未植入.术中高眼压虹膜脱出1眼,5 min后正常操作.术后并发症：术后1d角膜不同程度水肿者46眼,切口闭合差,房水渗漏1眼,高眼压1眼,皮质存留2眼,前房玻璃体存留2眼,玻璃体牵引瞳孔1眼,鼻侧少量玻璃体积血1眼及前葡萄膜炎1眼.术后3个月,未发生眼内炎、大泡性角膜病变或继发青光眼等并发症.结论 援非光明行实施超声乳化联合人工晶状体植入术效果良好,安全可靠.

Objective To observe the clinical efficacy and characteristic of 203 cataract patients in Brightness Action,Morocco.Methods Total 203 eyes of 203 cases of cataract underwent phacoemulsification combined with intraocular lens implantation by Chinese-Africa Action Expert Group in Morocco from Oct.8th,2016 to Oct.10th.The postoperative visual acuity,characteristic of lens opacity and complications were analyzed.Results The patients were followed up for 1-3 months.One week after operation,the visual acuity was 〈0.05 in 7 eyes （3.4%）,0.05-0.25 in 30 eyes （14.8%）,0.3-0.5 in 123 eyes （60.1%）,≥0.6 in 43 eyes （21.2%）.The rate out of blindness was 96.55%.During operation pseudoexfoliation syndrome occurred in 29 eyes and among them 16 eyes received radiate scissors of the sphincter of pupil.Posterior capsular rupture occurred in 6 cases,among them 2 cases received anterior vitrectomy combined with implantation of three piece IOL,1 case changed to extracapsular surgery without IOL implantation.Four cases of high myopia were operated without IOL implantation due to lens degree insufficiency.One case with iris prolapse caused by high intraocular pressure was continued normal operation after 5 minutes.The postoperative complications included varying degrees of corneal edema 1 day after operation in 46 eyes,poor closure of incision and leakage of aqueous humor in 1 eye,high intraocular pressure in 1 eye,residual cortex in 2 eyes,surviving anterior vitreous body in 2 eyes,vitreous traction pupil in 1 eye,1 eye of nasal minor vitreous hemorrhage and 1 eye of anterior uveitis.Three months after operation,no endophthalmitis,bullous keratopathy or secondary glaucoma happened.Conclusion The phacoemulsification combined with intraocular lens implantation in Brightness Action,Morocco can achieve good postoperative results,safe and reliable.