BACKGROUND Complicated cataract surgery is challenging,especially in cases of hard nuclear cataract with severe anterior capsule organization.It is important to avoid the risk of surgery and improve the surgical skill...BACKGROUND Complicated cataract surgery is challenging,especially in cases of hard nuclear cataract with severe anterior capsule organization.It is important to avoid the risk of surgery and improve the surgical skills of surgeons.CASE SUMMARY A 60-year-old man presented with severe cataract and visual impairment.The anterior capsule of the lens was irregularly organized and pulled to the surrounding capsule,and white porcelain organized cord and brown-black lens nucleus were clearly visible.In phacoemulsification,maintaining the anterior capsule round and intact plays a key role in a successful surgery.In this case,if the conventional capsule treatment method was used,the anterior capsule would be torn.Therefore,we adopted a segmented anterior capsule treatment method,and a blasting method to release energy when dealing with the lens nucleus,and achieved good surgical results.CONCLUSION Complicated cataract surgery is challenging and requires precise skills.Operation plans should be made reasonably to predict the risk of surgery,and improve the visual quality of the patients.展开更多
目的探讨高度近视眼白内障术后晚期自发性人工晶状体囊袋复合体脱位的发病机制、临床特点、治疗方法及预后。方法纳入北京同仁医院2006年9月—2017年9月收治高度近视眼白内障术后晚期自发性人工晶状体囊袋复合体脱位患者15例(15只眼)进...目的探讨高度近视眼白内障术后晚期自发性人工晶状体囊袋复合体脱位的发病机制、临床特点、治疗方法及预后。方法纳入北京同仁医院2006年9月—2017年9月收治高度近视眼白内障术后晚期自发性人工晶状体囊袋复合体脱位患者15例(15只眼)进行回顾性研究。观察发病时间、诱发因素、术前眼部情况、治疗方法等。结果(1)基本情况:15例患者中,男6例,女9例,男女比例为2:3;左眼10只,右眼5只,左右眼比例为2:1;年龄39~73岁,平均(57.00±9.19)岁;眼轴长度为26.22~34.81 mm,平均(29.76±2.76)mm;自发性人工晶状体囊袋复合体脱位发生时间最短为术后1年,最长为术后11年,平均(5.40±3.03)年。(2)伴随情况:糖尿病患者4例(26.67%),高血压患者6例(40.00%),另外5例无全身系统疾病(33.33%)。(3)诱发因素:1例有持重物史(6.67%),其余14例中发病均无明显诱发因素(93.33%)。(4)术前情况:矫正视力为眼前指数~0.4;平均眼压为13.6 mm Hg。(5)治疗方法:除3例患者因自身原因未手术外(20.00%),12例均行手术治疗。2例行玻璃体切除联合人工晶状体取出术(13.30%),未悬吊人工晶状体;6例行玻璃体切除联合原人工晶状体悬吊术(40.00%);4例行玻璃体切除联合人工晶状体取出及眼内光凝术,未悬吊人工晶状体(26.70%)。(6)术后情况:术后恢复较好,无并发症出现。结论高度近视眼白内障术后晚期自发性人工晶状体囊袋复合体脱位与晶状体悬韧带断裂和晶状体囊袋收缩关系密切。手术积极处理可挽救一定视力。展开更多
文摘BACKGROUND Complicated cataract surgery is challenging,especially in cases of hard nuclear cataract with severe anterior capsule organization.It is important to avoid the risk of surgery and improve the surgical skills of surgeons.CASE SUMMARY A 60-year-old man presented with severe cataract and visual impairment.The anterior capsule of the lens was irregularly organized and pulled to the surrounding capsule,and white porcelain organized cord and brown-black lens nucleus were clearly visible.In phacoemulsification,maintaining the anterior capsule round and intact plays a key role in a successful surgery.In this case,if the conventional capsule treatment method was used,the anterior capsule would be torn.Therefore,we adopted a segmented anterior capsule treatment method,and a blasting method to release energy when dealing with the lens nucleus,and achieved good surgical results.CONCLUSION Complicated cataract surgery is challenging and requires precise skills.Operation plans should be made reasonably to predict the risk of surgery,and improve the visual quality of the patients.
文摘目的探讨高度近视眼白内障术后晚期自发性人工晶状体囊袋复合体脱位的发病机制、临床特点、治疗方法及预后。方法纳入北京同仁医院2006年9月—2017年9月收治高度近视眼白内障术后晚期自发性人工晶状体囊袋复合体脱位患者15例(15只眼)进行回顾性研究。观察发病时间、诱发因素、术前眼部情况、治疗方法等。结果(1)基本情况:15例患者中,男6例,女9例,男女比例为2:3;左眼10只,右眼5只,左右眼比例为2:1;年龄39~73岁,平均(57.00±9.19)岁;眼轴长度为26.22~34.81 mm,平均(29.76±2.76)mm;自发性人工晶状体囊袋复合体脱位发生时间最短为术后1年,最长为术后11年,平均(5.40±3.03)年。(2)伴随情况:糖尿病患者4例(26.67%),高血压患者6例(40.00%),另外5例无全身系统疾病(33.33%)。(3)诱发因素:1例有持重物史(6.67%),其余14例中发病均无明显诱发因素(93.33%)。(4)术前情况:矫正视力为眼前指数~0.4;平均眼压为13.6 mm Hg。(5)治疗方法:除3例患者因自身原因未手术外(20.00%),12例均行手术治疗。2例行玻璃体切除联合人工晶状体取出术(13.30%),未悬吊人工晶状体;6例行玻璃体切除联合原人工晶状体悬吊术(40.00%);4例行玻璃体切除联合人工晶状体取出及眼内光凝术,未悬吊人工晶状体(26.70%)。(6)术后情况:术后恢复较好,无并发症出现。结论高度近视眼白内障术后晚期自发性人工晶状体囊袋复合体脱位与晶状体悬韧带断裂和晶状体囊袋收缩关系密切。手术积极处理可挽救一定视力。
