非超声乳化小切口白内障术中后囊膜破裂的临床分析
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Clinical analysis of posterior capsular rupture in small incision non-phacoemulsification cataract surgery
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    摘要:

    目的:探讨非超声乳化小切口白内障术中晶状体后囊膜破裂的临床原因及处理方法。

    方法:回顾分析108例121眼非超声乳化小切口白内障人工晶状体植入术,对术中6例6眼后囊破裂患者原因及处理方法进行分析和总结。

    结果:术中发生晶状体后囊破裂6例6眼(4.96%),其中术中植入后房型人工晶状体2例2眼,术后1wk行Ⅱ期睫状沟人工晶状体植入2例2眼,前房型人工晶状体植入2例2眼。术后1~3mo门诊复诊,矫正视力<0.1者1例1眼,为黄斑病变眼底; 0.3者1例1眼为糖尿病视网膜病变眼底; 0.4~0.6者2例2眼; >0.6者2例2眼,均无严重并发症。

    结论:晶状体后囊破裂为非超声乳化小切口白内障联合人工晶状体植入术中最常见并发症之一,可发生于术中任何步骤。术者提高手术操作技巧,并不断积累经验,可有效地减少后囊破裂的发生率; 即使术中出现后囊破裂,及时发现并妥善处理,患者术后仍可获得良好的手术效果。

    Abstract:

    AIM:To analyze the cause of posterior capsular rupture in small incision non-phacoemulsification cataract surgery and investigate the treatment methods.

    METHODS: The clinical data of 108 cases(121 eyes)undergone small incision non-phacoemulsification cataract surgery combined with intraocular lenses(IOL)implantation were retrospectively analyzed. The causes of posterior capsular rupture and treatment of 6 patients(6 eyes)after surgery were analyzed and summarized.

    RESULTS: Six cases(6 eyes, 4.96%)occurred posterior capsular rupture during the operation, of which 2 cases(2 eyes)underwent posterior chamber IOL implantation intraoperative, 2 cases(2 eyes)received Ⅱ stage IOL implantation in the ciliary sulcus at 1wk postoperative, 2 cases(2 eyes)were given anterior chamber IOL implantation. One case(1 eye)whose vision acuity <0.1 was macular degeneration; One case(1 eye )whose vision acuity=0.3 was diabetic retinopathy; 0.4~0.6 in 2 cases(2 eyes), 0.6~0.8 in 2 cases(2 eyes)after 1~3mo postoperatively. No severe syndrome was found after surgery.

    CONCLUSION: Posterior capsular rupture which occurs in different stages of the operation is the commonest intraoperative complication in small lincision non-phacoemulsification cataract surgery. With improving operative techniques, and continuously accumulating experience, incidence of posterior capsular rupture can be effectively reduced. Even posterior capsular rupture occurs intraoperative, patients can still get a good outcome after timely and proper treatment.

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王春红,梅立新.非超声乳化小切口白内障术中后囊膜破裂的临床分析.国际眼科杂志, 2015,15(8):1432-1434.

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  • 收稿日期:2015-05-05
  • 最后修改日期:2015-07-14
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  • 在线发布日期: 2015-08-05
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