Arbisser Lisa Brothers, Charles Steve, Howcroft Michael, Werner Liliana
Eye Surgeons Associates P.C., Iowa and Illinois Quad Cities, 777 Tanglefoot Lane, Bettendorf, IA 52722, USA.
Ophthalmol Clin North Am. 2006 Dec;19(4):495-506. doi: 10.1016/j.ohc.2006.07.002.
The intraoperative management of complication during cataract surgery of vitreous loss and dropped nucleus strongly influences the outcome, and a well-rehearsed plan for both staff and surgeons is needed. Preventative measures, early recognition, damage control, and resolution are discussed in this article. Maintenance of appropriate pressure relationships and tissue planes limits vitreous prolapse and the surgeon's primary goal is to avoid vitreous traction resulting in retinal tears and detachment. A pars plana approach to anterior vitrectomy with staining of the prolapsed vitreous is the most effective technique. Although residual lens material should be removed from the anterior and posterior chambers, once a fragment is lost to the posterior segment, the authors advocate referral for a standard three-port posterior vitrectomy with fragmenter as needed because the goal of the cataract surgeon is to offer the patient a clean, pseudophakic anterior segment and the best chance for an optimal visual recovery.
白内障手术中玻璃体丢失和晶状体核掉落并发症的术中管理对手术结果有很大影响，因此工作人员和外科医生都需要一个精心演练的计划。本文讨论了预防措施、早期识别、损害控制和解决方法。维持适当的压力关系和组织层面可限制玻璃体脱出，外科医生的主要目标是避免玻璃体牵拉导致视网膜裂孔和脱离。经睫状体平坦部入路行前部玻璃体切除术并对脱出的玻璃体进行染色是最有效的技术。虽然应从前房和后房清除残留的晶状体物质，但一旦有碎片掉入后节，作者主张根据需要转诊进行标准的三通道后段玻璃体切除术并使用晶状体粉碎器，因为白内障手术医生的目标是为患者提供一个干净的人工晶状体前段，并为最佳视力恢复提供最好的机会。
