Chan Elsie, Mahroo Omar A R, Spalton David J
Ophthalmology, St Thomas' Hospital, London, UK.
Clin Exp Optom. 2010 Nov;93(6):379-89. doi: 10.1111/j.1444-0938.2010.00516.x. Epub 2010 Aug 24.
Modern cataract surgery is safe in more than 95 per cent of patients. In the small number of cases where a serious complication occurs, the most common is an intra-operative posterior capsular rupture. This can lead to vitreous loss or a dropped nucleus and can increase the risk of post-operative cystoid macular oedema or retinal detachment. Post-operatively, posterior capsular opacification is the most common complication and can be readily treated with a YAG capsulotomy. The most devastating complication is endophthalmitis, the rate of which is now significantly decreased through the use of intracameral antibiotics. As a clinician, the most important step is to assess the patient pre-operatively to predict higher risk individuals and to counsel them appropriately. In these patients, various pre- or intra-operative management steps can be taken in addition to routine phacoemulsification to optimise their visual outcome.
现代白内障手术在超过95%的患者中是安全的。在少数发生严重并发症的病例中,最常见的是术中后囊破裂。这可能导致玻璃体丢失或晶状体核坠入玻璃体腔,并可能增加术后黄斑囊样水肿或视网膜脱离的风险。术后,后囊膜混浊是最常见的并发症,可通过YAG激光后囊切开术轻松治疗。最具破坏性的并发症是眼内炎,通过使用前房内抗生素,其发生率现已显著降低。作为一名临床医生,最重要的步骤是术前评估患者,以预测高风险个体并给予适当的建议。对于这些患者,除了常规的超声乳化手术外,还可以采取各种术前或术中管理措施,以优化他们的视觉效果。