摘要
目的探讨玻璃体切割联合晶状体切除及硅油填充术后的硅油取出联合人工晶状体(intraocular lens,IOL)悬吊术的手术方法,并评价其临床效果。方法选取矫正视力】0.05的视网膜复位良好的无晶状体硅油填充眼64例(64眼),均行硅油取出联合IOL悬吊术,观察患者术后视力,包括裸眼视力和矫正视力;裂隙灯检查眼前节,包括角膜、前房、瞳孔、IOL;眼科B超检查玻璃体、视网膜;直接检眼镜、间接检眼镜及前置镜检查眼底情况。结果术中所有患者前房维持正常,眼压基本稳定,无爆发性出血、视网膜脱离等不良情况发生。术后出现中度角膜水肿伴后弹力层皱褶16眼,轻度角膜水肿48眼;房水闪辉(++)17眼,房水闪辉(+)39眼;轻度玻璃体混浊10眼;瞳孔较大、欠圆8眼。63眼术前的矫正视力:0.05~0.1者29眼,0.12~0.2者17眼,0.25~0.5者13眼,】0.5者4眼;术后1周矫正视力:0.05~0.1者25眼,0.12~0.2者19眼,0.25~0.5者14眼,】0.5者5眼;术后1个月矫正视力0.05~0.1者26眼,0.12~0.2者16眼,0.25~0.5者16眼,】0.5者5眼;术后1周、1个月的矫正视力与术前比较,差异均无统计学意义(均为P】0.05);1眼术后1个月时因增生性玻璃体视网膜病变致视网膜脱离复发,在保留悬吊的IOL情况下再次行玻璃体切割和硅油填充术,使视网膜复位。结论硅油取出联合IOL悬吊术是一种安全、有效的术式。
Objective To introduce a method of silicone oil removal combined with intraocular lens(IOL)suspension following vitrectomy,lens excision and silicone oil padding,and evaluate its clinical effect.Methods A total of 64 aphakic eyes of 64 patients with well retinal reset were chosen,the corrected visual acuity was more than 0.05,all eyes underwent silicone oil removal combined with IOL suspension,the postoperative uncorrected visual acuity and corrected visual acuity were examined,the cornea,anterior chamber,pupil and IO L were observed by slit lamp,the vitreous body and retina were scanned by B ultrasound,and the fundus was examined by direct and indirect ophthalmoscope.Results The intraoperative anterior chamber of all eyes were maintained normal,the intraocular pressure was stabled,no burst bleeding and retinal detachment appeared.The postoperative moderate corneal edema and Descemet's membrane reductus appeared in 16 eyes,slight corneal edema in 48 eyes,aqueous humor turbid(++)in 17 eyes,aqueous humor turbid(+)in 39 eyes,slight vitreous opacity in 10 eyes,large and oval pupil in 8 eyes. The preoperative corrected visual acuity was from 0.05 to 0.1 in 29 eyes,from 0. 12 to 0.2 in 17 eyes,from 0.25 to 0.5 in 13 eyes,more than 0.5 in 4 eyes.The postoperative corrected at 1 week was from 0.05 to 0.1 in 25 eyes,from 0.12 to 0. 2 in 19 eyes,from 0.25 to 0.5 in 14 eyes,more than 0.5 in 5 eyes;Which at 1 month was from 0.05 to 0.1 in 26 eyes,from 0.12 to 0.2 in 16 eyes,from 0.25 to 0.5 in 16 eyes,more than 0.5 in 5 eyes;Compared with pre-operation,there was no statistical difference in corrected visual acuity at postoperative 1 week and 1 month(all P>0.05).The retinal redetachment induced by proliferative vitreoretinopathy appeared in 1 eye at postoperative 1 month,the vitrectomy and silicone oil padding was remade under reserving the IOL suspension,and the retina was reduced.Conclusion The method of silicone oil removal combined with IOL suspension is a safe and effective.
出处
《眼科新进展》
CAS
北大核心
2013年第12期1162-1165,共4页
Recent Advances in Ophthalmology
