透明角膜切口超声乳化白内障吸除人工晶状体植入术并发症回顾性分析
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摘要
目的探讨引起透明角膜切口超声乳化白内障吸除人工晶状体植入术并发症发生的风险因素。方法选择2015年4月~2017年8月我院透明角膜切口白内障摘出人工晶状体植入患者447例(468眼),分析其相关危险因素、并发症等情况。结果术中后囊膜破裂13眼占2.77%,环形撕囊失败8眼占1.70%,术后角膜内皮水肿198眼占42.3%,眼内炎1眼占0.2%,高眼压9眼占1.92%。出院时视力≥0.3者391眼,占83.5%;0.05~0.3者38例,占8.1%;<0.05者39眼,占8.3%。结论注意透明角膜切口超声乳化白内障吸除人工晶状体植入术并发症的风险因素,应从根本上对风险因素进行有效地控制,有助于减少术中、术后并发症,从而提高临床上白内障超声乳化术的成功率。
Objective To investigate the risk factors of complications after phacoemulsification and intraocular lens implantation with clear corneal incision. Methods A total of 447 cases(468 eyes) of cataract extraction and intraocular lens implantation with transparent corneal incision from April 2015 to August 2017 in our hospital were selected,the related risk factors and complications were analyzed. Results Posterior capsular rupture in 13 eyes accounted for2.77%,annular capsulorhexis failed in 8 eyes accounted for 1.70%,postoperative corneal edema in 198 eyes accounted for 42.3%,endophthalmitis in 1 eye accounted for 0.2%,high intraocular pressure in 9 eyes accounted for 1.92%. Discharge of visual acuity more than 0.3 in 391 eyes accounted for 83.5%;0.05 to 0.25 in 38 cases accounted for 8.1%;<0.05 in 39 eyes accounted for 8.3%. Conclusion we pay attention to the risk factors of complications after phacoemulsification and intraocular lens implantation with clear corneal incision,the risk factors should be effectively controlled in order to reduce the intraoperative and postoperative complications and improve the success rate of phacoemulsification in clinic.
Objective To investigate the risk factors of complications after phacoemulsification and intraocular lens implantation with clear corneal incision. Methods A total of 447 cases(468 eyes) of cataract extraction and intraocular lens implantation with transparent corneal incision from April 2015 to August 2017 in our hospital were selected,the related risk factors and complications were analyzed. Results Posterior capsular rupture in 13 eyes accounted for2.77%,annular capsulorhexis failed in 8 eyes accounted for 1.70%,postoperative corneal edema in 198 eyes accounted for 42.3%,endophthalmitis in 1 eye accounted for 0.2%,high intraocular pressure in 9 eyes accounted for 1.92%. Discharge of visual acuity more than 0.3 in 391 eyes accounted for 83.5%;0.05 to 0.25 in 38 cases accounted for 8.1%;<0.05 in 39 eyes accounted for 8.3%. Conclusion we pay attention to the risk factors of complications after phacoemulsification and intraocular lens implantation with clear corneal incision,the risk factors should be effectively controlled in order to reduce the intraoperative and postoperative complications and improve the success rate of phacoemulsification in clinic.
引文
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[2]顾若姝,梁斗立,于雪冰,等.白内障临床治疗探讨[J].中国现代药物应用,2010,4(1):80.
[3]敖明昕,王薇,李学民,等.超声乳化白内障吸除联合人工晶状体植入术后运动视标分辨力的变化[J].中华眼科杂志,2013,49(5):405-409.
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[10]邹德,兰琼.透明角膜切口白内障超声乳化折叠人工晶体植入术的临床观察[J].川北医学院学报,2008,23(1):38-39.
[11]曹燕,赵俊宏,梁厚成,等.超声乳化白内障吸除术和小切口非超声乳化囊外摘除术在高龄白内障患者中的疗效对比分析[J].中国医学前沿杂志,2014,6(10):29-33.
[12]何小杰,马瑞倩,叶润才,等.高龄白内障患者两种小切口手术的比较[J].广东医学,2011,32(18):2439-2441.
[13]孙理彬.硬核性白内障行小切口白内障摘除术和超声乳化白内障吸除术的效果观察[J].中华眼科杂志,2014,4(1):15-18.
[14]高波.超声乳化术与现代囊外摘除术对硬核性白内障角膜内皮的影响[J].中国现代医生,2014,52(29):10-12.
[15]许昌林.表面麻醉下小切口非超生乳化硬核白內障手术的临床观察[J].中国伤残医学,2016,24(2):83-84.
[16]曹向荣,龚力力,杨漪,等.超声乳化白内障吸除术后眼内炎的临床分析[J].中华眼科杂志,2005,41(6):519-522.
[17]陈世久,秦梅,李宁.严重粘连性小瞳孔的白内障超声乳化术[J].临床眼科杂志,2015,15(2):157-159.
[18]胡博杰,李筱荣.白内障手术晶状体后囊破裂的临床分析[J].中国实用眼科杂志,2009,27(11):1305-1308.
[19]刘颖,杨红.白内障超声乳化联合人工晶体植入术并发症的临床分析[J].临床和实验医学杂志,2008,7(2):57-58.
[20]王祥群,曾骏文.劈核乳化白内障吸除术中后囊破裂的临床分析[J].中国实用眼科杂志,2005,23(11):1212-1214.
[21]朱俊东,谢丽莲,陈文芳.白内障超声乳化术的并发症及处理[J].国际眼科杂志,2013,13(1):88-91.
[22]徐方.2320只眼超声乳化白内障手术的临床回顾与分析[J].临床眼科杂志,2005,13(6):535-537.
[23]吴泽勇,杨亚新,李新霞.白内障Phaco+IOL术入门30例体会[J].农垦医学,2015,37(4):328-330.
[23]郑煜,张少斌,黄惠春.白内障超声乳化手术的并发症原因分析及防治[J].汕头大学医学院学报,2007,20(2):115-116.
[24]盛耀华,叶向彧.超声乳化处理眼前节拥挤征[J].上海交通大学学报(医学版),2008,28(6):752-754.
[2]顾若姝,梁斗立,于雪冰,等.白内障临床治疗探讨[J].中国现代药物应用,2010,4(1):80.
[3]敖明昕,王薇,李学民,等.超声乳化白内障吸除联合人工晶状体植入术后运动视标分辨力的变化[J].中华眼科杂志,2013,49(5):405-409.
[4]施玉英.超声乳化摘除术[M].北京:人民卫生出版社,1996:21-22.
[5]王青,廖荣丰,刘兴华,等.小切口非超声乳化术中不同位置的切口对术后角膜散光度及角膜内皮细胞变化的影响[J].实用防盲技术,2011,6(2):62-65,83.
[6]王明举,周开遗.超声乳化术中并发症分析[J].中国实用眼科杂志,1998,16(4):216-217.
[7]姚克,姜节凯,徐雯,等.透明角膜切口的白内障超声乳化摘除及折叠式人工晶状体植入术[J].中华眼科杂志,1998,34(2):87-89.
[8]Kohnen T,Dick B,Jacobi KW.Comparison of the in duced astigmatism after temporal Clear Corneal tunnel incisions of different sizes[J].JCataract Re fract Surg,1995,21(1):417-424.
[9]覃光海,王平,岳军.透明角膜切口白内障手术后的临床效果观察[J].眼外伤职业眼病杂志,2004,26(12):819-820.
[10]邹德,兰琼.透明角膜切口白内障超声乳化折叠人工晶体植入术的临床观察[J].川北医学院学报,2008,23(1):38-39.
[11]曹燕,赵俊宏,梁厚成,等.超声乳化白内障吸除术和小切口非超声乳化囊外摘除术在高龄白内障患者中的疗效对比分析[J].中国医学前沿杂志,2014,6(10):29-33.
[12]何小杰,马瑞倩,叶润才,等.高龄白内障患者两种小切口手术的比较[J].广东医学,2011,32(18):2439-2441.
[13]孙理彬.硬核性白内障行小切口白内障摘除术和超声乳化白内障吸除术的效果观察[J].中华眼科杂志,2014,4(1):15-18.
[14]高波.超声乳化术与现代囊外摘除术对硬核性白内障角膜内皮的影响[J].中国现代医生,2014,52(29):10-12.
[15]许昌林.表面麻醉下小切口非超生乳化硬核白內障手术的临床观察[J].中国伤残医学,2016,24(2):83-84.
[16]曹向荣,龚力力,杨漪,等.超声乳化白内障吸除术后眼内炎的临床分析[J].中华眼科杂志,2005,41(6):519-522.
[17]陈世久,秦梅,李宁.严重粘连性小瞳孔的白内障超声乳化术[J].临床眼科杂志,2015,15(2):157-159.
[18]胡博杰,李筱荣.白内障手术晶状体后囊破裂的临床分析[J].中国实用眼科杂志,2009,27(11):1305-1308.
[19]刘颖,杨红.白内障超声乳化联合人工晶体植入术并发症的临床分析[J].临床和实验医学杂志,2008,7(2):57-58.
[20]王祥群,曾骏文.劈核乳化白内障吸除术中后囊破裂的临床分析[J].中国实用眼科杂志,2005,23(11):1212-1214.
[21]朱俊东,谢丽莲,陈文芳.白内障超声乳化术的并发症及处理[J].国际眼科杂志,2013,13(1):88-91.
[22]徐方.2320只眼超声乳化白内障手术的临床回顾与分析[J].临床眼科杂志,2005,13(6):535-537.
[23]吴泽勇,杨亚新,李新霞.白内障Phaco+IOL术入门30例体会[J].农垦医学,2015,37(4):328-330.
[23]郑煜,张少斌,黄惠春.白内障超声乳化手术的并发症原因分析及防治[J].汕头大学医学院学报,2007,20(2):115-116.
[24]盛耀华,叶向彧.超声乳化处理眼前节拥挤征[J].上海交通大学学报(医学版),2008,28(6):752-754.