外伤晶状体半脱位白内障微小切口手法碎核乳化术的临床应用
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Clinical application of incision cataract extraction after manual fragmentation and emulsification of nucleus for traumatic lenssubluxation and cataract
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    摘要:

    目的:探讨并观察外伤性晶状体半脱位合并白内障的3.0mm小切口白内障手法碎核乳化摘除联合折叠式人工晶状体植入术的手术方法和手术效果。

    方法:对26例26眼外伤性晶状体半脱位(悬韧带断裂范围≤120°)合并白内障(晶状体核硬度I~Ⅲ级)的患者于晶状体悬韧带正常处中部作3.0mm带球结膜的角巩膜缘隧道式切口,将核劈开、挤压或搅碎乳化后摘除并联合折叠式人工晶状体植入,人工晶状体襻顶置入晶状体悬韧带断裂处中间以复位囊袋,观察手术并发症及术后视力变化。

    结果:术后视力均有不同程度提高,术后3mo视力0.2~0.4者5眼(19%),0.5~0.8者21眼(81%); 晶状体位置不偏心者22眼(85%),轻度偏心(1~2mm)者4眼(15%)。术后24h内眼压升高12眼(46%),2~7d后恢复正常。无其他严重术中、术后并发症。

    结论:对轻中度外伤性晶状体半脱位合并白内障采用3.0mm角巩膜缘隧道式切口的白内障手法碎核乳化联合折叠式人工晶状体植入术,是一种较为简便有效、安全的手术方式。

    Abstract:

    AIM: To observe the surgical effects of the taumatic lens subluxation and cataract after manual fragmentation and emulsification of nucleus and foldable intraocular lens implantation.

    METHODS: A 3.0mm tunnel limbus incision was operated through the predicted bulbar conjunctiva and sclera on 26 cases(26 eyes)with taumatic lens subluxation(suspensory ligament rupture range less than 120)and cataract(Ⅰ~Ⅲ). And after the manual fragmentation and emulsification of nucleus, foldable intraocular lens was implantated. Intraocular lens loop was imbedded in the middle of the lens zonular ligament breakup to reset the pouch. The surgical complications and postoperative vision changes were observed.

    RESULTS: Three month after operation, 22 eyes had a intraocular lens centric position taking up 85% of the whole. Four eyes had a slightly eccentric position(1~2mm), taking up 15% of the whole. 21 eyes had their visual acuity 0.5~0.8, taking up 81% of the whole. Five eyes of visual acuity was 0.2~0.8. Within 24h intraocular pressure of 12 eyes(46%)after operation were elevated, and returned to normal after 2~7d. There was no severe complication during operation and postoperation.

    CONCLUSION: The manual fragmentation and emulsification of nucleus and foldable intraocular lens implantation of the traumatic lens subluxation and the cataract through the 3.0mm corneal sclera limbus tunnel incision is a simple and effective surgery.

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曾先国,钟守国,冯静平,等.外伤晶状体半脱位白内障微小切口手法碎核乳化术的临床应用.国际眼科杂志, 2015,15(4):699-670.

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  • 收稿日期:2014-11-23
  • 最后修改日期:2015-03-20
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  • 在线发布日期: 2015-04-08
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