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目的评价超声乳化人工晶状体植入术对有玻璃体切割手术史白内障患者的治疗效果,并讨论该手术的适应症、手术技巧、手术并发症及处理。方法采用拦截—劈裂技术和囊膜上超声乳化法对23例(24眼)玻璃体切割术后的白内障患者进行了超声乳化并人工晶状体植入术,其中晶状体核硬度Ⅱ级7眼,Ⅲ级15眼,Ⅳ级2眼。结果手术后矫正视力0.050.1者2眼,0.15者1眼,0.2～0.3者5眼,0.4～0.6者14眼,0.8～1.0者眼。随访1a以上均未见发生视网膜脱离。结论超声乳化人工晶状体植入术适用于有玻璃体切割手术史的白内障患者,但手术适应症应严格掌握。术前需进行详细的眼部检查,手术过程较其它白内障手术有其特殊性,术中应尽可能维持较稳定的眼内压,操作技术必须熟练。对玻璃体手术后发生白内障的患者,一日视物明显模糊,应争取尽早手术。
Objective To evaluate the therapeutic effect of phacoemulsification and intraocular lens implantation on patients with history of cataract with vitrectomy and to discuss the indications, surgical techniques, surgical complications and management of the operation. Methods 23 patients (24 eyes) with cataract after vitrectomy were treated by phacoemulsification and intraocular lens implantation by interception and cleavage technique and phacoemulsification. Among them, 7 cases had grade Ⅱ of lens nucleus and Ⅲ grade 15 eyes, Ⅳ grade 2 eyes. Results The postoperative corrected visual acuity was 0.050.1 in 2 eyes, 0.15 in 1 eye, 0.2 to 0.3 in 5 eyes, 0.4 to 0.6 in 14 eyes and 0.8 to 1.0 in eyes. Retinal detachment was not seen at more than 1 year follow-up. Conclusion Phacoemulsification and intraocular lens implantation are suitable for cataract patients who have a history of vitrectomy. However, surgical indications should be strictly controlled. Preoperative detailed examination of the eye, the surgical process than other cataract surgery has its own particularity, surgery should be to maintain a more stable intraocular pressure, the operating skills must be proficient. In patients with cataract after vitreous surgery, the visual acuity of the first day is obviously obscure and surgery should be strived for as soon as possible.