25G微创系统在玻璃体切除术后白内障手术中的应用

摘要

目的:观察25G微创系统在玻璃体切除术后白内障手术中的治疗效果,为玻璃体切割术后并发白内障患者提供安全有效的手术选择.方法:选择玻璃体切除术后并发白内障患者29例(30只眼),均行25G 微创玻璃体腔灌注下白内障超声乳化联合人工晶状体植入术,观察术后最佳矫正视力(BCVA)、眼压、角膜内皮细胞丢失率及术中和术后并发症.结果:所有患者均顺利完成手术.30只眼中,术后1个月 BCVA≥0.5者5只眼,0.3~0.5者8只眼,0.1~0.3者9只眼,指数~0.1者8只眼;与术前比较,术后1个月 BCVA差异均有统计学意义(P0.05).术前角膜内皮细胞计数平均为(2467 ± 280)mm-2,术后7 d平均为(2033±209)mm-2,角膜内皮细胞丢失率为17.59%.患者术后无视网膜脱离、脉络膜脱离、后囊破裂及爆发性脉络膜出血等严重并发症发生.结论:应用25G微创系统行玻璃体切除术后白内障超声乳化术可稳定眼压,减少并发症,并有效地提高手术的安全性.%Objective:To observe the curative effect of 25-gauge mini-invasive system in cataract surgery after vitrectomy,and to provide a safe operation method for the patients with cataract induced by vitrectomy. Methods:A total of 29 patients(30 eyes)with cataract after vitrectomy were selected. Phacoemulsification and implantation of artificial lens with 25-gauge mini-invasive irrigation system were performed in the patients.The best corrected visual acuity(BCVA),intraocular pressure(IOP),corneal endothelial cell loss rate,intraoperative and postoperative complications of the patients were observed.Results:All the patients received the operation successfully.One month after operation,BCVA≥0.5 were found in 5 eyes,0.3-0. 5 in 8 eyes,0.1-0.3 in 9 eyes,Fc-0.1 in 8 eyes;the BCVA 1 month after operation had significant differences compared with before operation(P0.05).The number of corneal endothelial cells before operation was(2 467±280)mm-2and the number after operation was(2 033±209)mm-2;the loss rate of corneal endothelial cells was 17.59%.There were no sever complications such as retinal redetachment,detachment of choroid,capsular rupture or suprachoroidal hemorrahage.Conclusion:Phacoemulsification for cataract after vitrectomy with 25G mini-invasive system way can maintain the IOP,reduce the complications and enhance the security in cataract surgery.