Hoeve Maretta, Stilma Jan
Universitair Medisch Centrum Utrecht, afd. Oogheelkunde, Utrecht, The Netherlands.
Ned Tijdschr Geneeskd. 2010;154:A1797.
In 0.1% to 1% of cases cataract extraction is complicated by luxated lens fragments, also known as 'dropped nucleus'. Dropped nucleus can lead to severe complications such as glaucoma or retinal detachment. After incomplete cataract extraction visual acuity is poor. Although a few patients with dropped nucleus may heal with medication alone, pars plana vitrectomy is indicated in most of cases. Pars plana vitrectomy entails the removal of luxated lens fragments and placement of an artificial lens if necessary. It is recommended that pars plana vitrectomy be performed within one to two weeks after cataract extraction. It allows recovery of visual acuity in most of cases. It is important that cataract patients should be informed about the possibility of a dropped nucleus before the extraction.
在0.1%至1%的病例中,白内障摘除术会因晶状体碎片脱位而变得复杂,这种情况也被称为“晶状体核坠落”。晶状体核坠落可导致严重并发症,如青光眼或视网膜脱离。不完全白内障摘除术后视力较差。虽然少数晶状体核坠落患者可能仅通过药物治疗就能康复,但大多数情况下仍需行玻璃体切除术。玻璃体切除术需要取出脱位的晶状体碎片,并在必要时植入人工晶状体。建议在白内障摘除术后一至两周内进行玻璃体切除术。在大多数情况下,这能使视力恢复。重要的是,应在白内障摘除术前告知患者晶状体核坠落的可能性。