摘要
目的评价成人后极性白内障的临床特点、手术技巧和疗效。方法回顾性分析连续病例20例30眼，总结术前术中后囊情况、手术技巧、术中并发症以及术后视力恢复情况。结果术中后囊完整透明14眼（占46．7％），病理性后囊16眼（占53．3％），其中术前后囊破裂2眼（占6．7％），中央后囊缺损1眼（占3．3％），点状混浊但保持完整8眼（占全部病例的26．7％），后极偏鼻下混浊伴原始玻璃体动脉残留但保持后囊完整1眼（占3．3％），术中后囊破裂4眼（占13．3％）。2眼在轻柔水分层时出现破裂，2眼在试图清除后囊点状混浊时破裂。26眼囊袋内植入人工晶状体．4眼睫状沟植入。术后矫正视力：0．1-0．3者7例7眼（占23．3％），0．4—0．8者2例3眼（占10％），1．0～1．2者11例20眼（占66．7％）。结论后极性白内障很可能具有后囊先天异常、后囊破裂或缺损，可能术前已经存在或术中发生，充分的术前散瞳检查、轻柔的水分层、不作后囊抛光是避免术中并发症和提高手术预后的关键。大部分患者视力均明显提高，单眼患者视力恢复较差。
Objective To evaluate the charocteristics of the posterior pole cataract and to evaluate the techniques for surgical management and surgical outeomes.Methods This retrospective study included 30 eyes of 20 consecutive patients. The characteristics of the posterior capsule and lens opacities were examined after the pupil was dilated. The surgical techniques used, intraoporative complications, and preoperative and postoperative visual acuities were also evaluated. Results There was integrity in 14 eyes, there was a clear posterior capsule in 30 eyes （46.7%） and 16 eyes （53.3%） revealed pathological complications. Posterior capsule rupture was present before surgery in 2 eyes （6.7%）, the central area of the posterior capsule was defective in 1 eye （3.3%）, there, was integrity in the posterior capsule with dot opacity in 8 eyes （26.7%）, and the nasal portion of the primary vitreous artery showed opacity in 1 eye （3.3%）. Four eyes （ 13.3% ） developed posterior capsule rapture using D/E neutralizer broth as a neutralizer, including 2 eyes after gentle hydredelineation and 2 eyes during polishing opacity on the posterior capsule. An intraocular lens （IOL） was implanted in all 30 eyes. Twenty eyes （66.7%） of 11 cases had a visual acuity of 20/20, 3 eyes （10%） of 2 cases had 20/25 to 20/50,and 7 eye （23.3%） of 7 cases had 20/60 to 20/200. Conclusion Posterinr pole cataracts probably have posterior capsule rapture or deficiency before surgery, or develop rapture during surgery. Detailed examination before surgery, using gentle hydrodelineafion instead of hydrodissection and avoiding polishing the posterior ease are the. key factors in avoiding complications and improving outcomes.
出处
《眼视光学杂志》
2006年第4期255-256,259,共3页
Chinese Journal of Optometry & Ophthalmology
关键词
白内障
后极性
后囊破裂
临床特点
手术技巧
posterior polar cataract
posterior capsule
clinical characters
.surgical techniques
