瞳孔膜闭时膜摘除术的临床研究

Clinical study on the membranectomy of occlusion of pupil

目的 :探讨药物不能消除的前葡萄膜炎瞳孔膜闭时透明晶状体前膜的手术介入方式 ,通过本研究评价该术式的临床效果。方法 :对符合适应证的 2 8例 (2 8眼 )施行了显微镜下粘弹剂参与的膜摘除术 ,并对其手术方式、时机、效果以及合并症进行回顾性分析。结果 :2 8例 (2 8眼 )的渗出膜均一次性被完整摘除。术后不同程度的虹膜炎症反应经药物治疗后 3～ 5d内全部消失。随访时见瞳孔全部保持圆形或类圆形 ,光反射全部可引出 ,术后第 1个月时的视力即恢复至患者主诉的病前水平。无 1例医源性晶状体损伤。手术分离的难易程度、并发症与病程有关。结论 :对药物不能消除的瞳孔膜闭症适时在手术显微镜下通过粘弹剂的参与予以摘除 ,能够避免晶状体损伤和难以控制的炎症反应 ,以及因粘连所致的各种并发症 。

Objective:To expore the operative ways of interposition of anterior lens capsule of occlusion of pupil caused by anterior uveitis that medicine can't remove. To appraise the clinical offect of this operative way through this study.Methods:The materials of 28 patients(28 eyes) with membranectomy done under the operating microscope with the help of viscoetastic were reviewed and analyzed retrospectively.Results:The exudative membranec of pupil of 28 patients(28 eyes) were completely extracted just by one operation. The iritis of different degrees were all controlled medically after three to five days. An their pupils kept round or like that with reaction of pupil to light. Their eyesight recovered completely as usual one month later. There were no iatrogenic lens rupture. The difficulty of the aperture breakaway and the complication are connected with how long the illness has been.Conclusion:The extraction of occlusion of pupil,under the operative microscope with the help of viscoelastic, can avoid lens rupture and the inflammation that are not easily controlled. And it is also a safe and authentic operative way to all kinds of complications caused by adhesion.