硅油充填眼行白内障超声乳化人工晶状体植入联合硅油取出术

Cataract extraction,intraocular lens implantation and removal silicone oil in the eyes with silicone oil temponade

目的 探讨玻璃体切割术后硅油充填眼经透明角膜切口行白内障超声乳化摘除、硅油取出、人工晶状体植入联合手术 (1组 )以及经睫状体平坦部置灌注管行白内障超声乳化摘除、硅油取出、人工晶状体植入 (2组 )两种手术方式的临床疗效观察。方法 对 2 0 0 0年 1月～ 2 0 0 3年 4月间玻璃体切割术后硅油充填眼白内障患者 78例 (78只眼 )经透明角膜行联合手术。对 4 9例 (4 9只眼 )经睫状体平坦部行联合手术。观察眼底视网膜复位良好 ,行人工晶状体植入术。结果 1组病例有中 5 2只眼最佳矫正视力达 0 .1～ 0 .6 (6 6 .6 7% ) ;19只眼视力为 0 .0 2～ 0 .1(2 4 .36 % ) ;7只眼视力为光感～指数 (8.97% ,包括 5只眼视网膜脱离复发者 )。2组病例中 31只眼最佳矫正视力达0 .1～ 0 .6 (6 5 .3% ) ;11只眼视力为 0 .0 2～ 0 .1(2 2 .4 5 % ) ;7只眼视力为光感～指数 (14 .3% ,包括 2只眼视网膜脱离复发者 )。 2组病例中有 1只眼出现睫状体平坦部切口渗血 ,所有病例均无持续性角膜内皮失代偿、硅油泡残留、人工晶状体移位等并发症发生。结论 硅油眼行白内障超声乳化、硅油取出、人工晶状体植入术对于玻璃体切除手术后硅油充填眼并发白内障是一种安全、有效的方法。经透明角膜切口行此手术简化了手术步骤 。

Objective To evaluate the therapeutic effect of two kinds of combined surgery on cataract after vitrectomy.Methods 78 patients underwent phacoemulsification intraocular lens implantation combined with removal of silicone oil,which had served as intraocular tamponade after pars plana vitrectomy,through the cleaning corneal incision (group 1).And 49 patients underwent the combined surgery through the ciliary body flat incision (group 2).Results Of the group 1,52 eyes had obtained post-operative visual acuity ≥0.1 (66.67%),19 eyes between 0.02～0.1 (24.36%),7 eyes between light perception～finger count(14.30%).And of the group 2,31 eyes had obtained post-operative visual acuity ≥0.1 (65.30%),11 eyes between 0.02～0.1 (22.45%),7 eyes between light perception ～finger count (14.30%).Post-operative complication was recurrent retinal detachment and bleeding around the ciliary body flat incision.Vitreous hemorrhage,persisting corneal endothelial,nesidual silicone oil and lens dislocation due to combined surgery were not observed in any patients.Conclusion The combined surgery through the cleaning corneal incision is a safe,effective approach,it simplifies the procedur,and reduces post-operative complication.