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目的探讨玻璃体切割术后的白内障患者行玻璃体灌注下的白内障超声乳化术特点、手术并发症和视力预后。方法对52例52只眼玻璃体切除术后白内障行玻璃体灌注下的白内障超声乳化术,观察记录术中情况、术中术后并发症和视力预后。结果2只眼在白内障超声乳化术中出现“灌注偏离综合症”,39只眼可见角膜后壁细小灰白色乳化硅油集聚并排出眼外。所有病例未出现巩膜塌陷、晶状体掉入玻璃体腔等术中并发症,11只眼术中发现后囊混浊机化,其中9只眼行后囊连续环行撕囊术并植入后房型人工晶状体,2例撕除全部后囊植入前房型人工晶状体。52只眼术后视力较术前提高,术后并发症少。结论对曾行硅油填充、虹膜后粘连、小瞳孔、多次手术后低眼压、怀疑晶状体损伤的复杂性玻璃体切割术后白内障患者在超声乳化术中应行玻璃体腔液体灌注以利手术操作和减少手术并发症,提高手术质量。
Objective To investigate the characteristics of cataract phacoemulsification under vitreous perfusion in patients with cataract after vitrectomy, complications of surgery and visual acuity prognosis. Methods 52 patients (52 eyes) with cataract after 52 vitreous cataract were treated with phacoemulsification under vitreous perfusion. The intraoperative and postoperative complications and visual acuity prognosis were observed and recorded. Results In the two eyes, “Deviation syndrome” occurred during cataract phacoemulsification. In 39 eyes, fine grayish white emulsion silicone oil was collected on the posterior wall of the cornea and excreted. In all cases, there was no scleral collapse and intraocular lens dislocation in the vitreous cavity. Among the 11 cases, posterior capsular opacification was found. Among them, 9 eyes underwent posterior capsulorhexis and were implanted into the posterior chamber intraocular lens (IOL) 2 cases of all posterior capsulotomy ripped anterior chamber intraocular lens implantation. 52 eyes postoperative visual acuity increased compared with preoperative, postoperative complications less. Conclusions For patients with cataract after phacoemulsification, vitrectomy should be carried out in order to facilitate the surgical operation and improve the intraocular pressure after the operation of silicone oil filling, posterior synechia, small pupil, multiple intraocular pressure and suspected lens injury after vitrectomy Reduce surgical complications and improve the quality of surgery.