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[掌握该方法过程中白内障超声乳化术并发症的分析]

[Analysis of phacoemulsification complications during mastering of the method].

作者信息

Popiela Grazyna, Markuszewska Jolanta, Chełstowska Joanna, Szaliński Marek

机构信息

Katedry i Kliniki Okulistyki Akademii Medycznej we Wrocławiu.

出版信息

Klin Oczna. 2004;106(1-2):23-7.

Abstract

PURPOSE

Intra-operative and postoperative complications of the first 50 phacoemulsifications were evaluated. The procedures were performed by one, skilled at ECCE surgeon. The phaco-chop technique was carried out in all cases with use of anterior chamber maintainer (ACM).

MATERIAL AND METHODS

Eyes for surgery met the requirements: normal comea, presence of red reflex from the fundus and correct lens position. The patients were divided into 2 groups: I group--25 eyes had first surgery, II group--25 eyes had second surgery. On the first day after surgery complications and uncorrected acuity were evaluated.

RESULTS

50 eyes of 48 patients underwent operation. The mean age was 69.4 years 5% eyes had previous surgical record: 4--underwent trabeculectomy, 1--pars plana vitrectomy. The 12 intra-operative complications appeared in 10 eyes (20%): posterior capsule rupture without vitreous loss in 4% and 10% with vitreous loss, Descemet membrane detachment in 4%, iris dialysis in 2%, and persistent iris damage without sphincter disruption in 4%. The 16 postoperative complications concerned 10 eyes (20%): corneal oedema in 20%, transient intra-ocular pressure raise in 8%, hyphaema in 2%, and fibrin exudation in 2%. The majority of complications concerned the I group of eyes. The uncorrected visual acuity was 0.5 or better in 80% of eyes, on the first day after the operation.

CONCLUSIONS

The use of ACM made the first steps in phacoemulsification rate during the learning course.

摘要

目的

评估前50例超声乳化白内障吸除术的术中及术后并发症。手术由一位擅长囊外白内障摘除术的外科医生进行。所有病例均采用前房维持器(ACM)进行超声乳化劈核技术。

材料与方法

手术眼符合以下条件:角膜正常、眼底有红色反光且晶状体位置正确。患者分为2组:I组——25只眼为首次手术,II组——25只眼为二次手术。术后第一天评估并发症及未矫正视力。

结果

48例患者的50只眼接受了手术。平均年龄为69.4岁。5%的眼有既往手术史:4只眼曾行小梁切除术,1只眼曾行玻璃体切除术。10只眼(20%)出现12例术中并发症:4%的患者后囊膜破裂无玻璃体脱出,10%的患者后囊膜破裂伴有玻璃体脱出,4%的患者后弹力层脱离,2%的患者虹膜根部离断,4%的患者虹膜持续性损伤但瞳孔括约肌未中断。10只眼(20%)出现16例术后并发症:20%的患者角膜水肿,8%的患者短暂眼压升高,2%的患者前房积血,2%的患者纤维蛋白渗出。大多数并发症发生在I组眼。术后第一天,80%的眼未矫正视力为0.5或更好。

结论

在前房维持器的辅助下,术者在学习超声乳化白内障吸除术的过程中迈出了第一步。

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