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[白内障手术所致脉络膜上腔出血的外科治疗——病例系列]

[Surgical management of suprachoroidal haemorrhages induced by cataract surgery--case series].

作者信息

Pietraś-Trzpiel Małgorzata, Rejdak Robert, Choragiewicz Tomasz, Latalska Małgorzata, Zarnowski Tomasz

机构信息

Z Katedry i Kliniki Okulistyki Uniwersytetu Medycznego w Lublinie.

出版信息

Klin Oczna. 2011;113(10-12):331-5.

Abstract

PURPOSE

Suprachoroidal hemorrhage (SCH) is a rare complication occurring during surgery (early SCH) or 3-5 days after operation as a delayed suprachoroidal hemorrhage. It occurs more often in patients who have complicated cataract surgery with vitreous loss or lens dislocation. The purpose of this study was to present surgical treatment of 7 patients with suprachoroidal hemorrhage due to cataract surgery.

MATERIAL AND METHODS

Mean age of patients was 72,4 years old. There were 3 female and 4 male. Six patients were operated using phacoemulsification, one patient- using ECCE. In 3 cases the vitreous loss and lens dislocation occurred during operation.

RESULTS

Suprachoroidal drainage was performed in 4 patients. In 3 patients suprachoroidal drainage was followed by vitrectomy. In this group in 2 patients injection of silicone oil was done. Anterior infusion line was used in all cases. Drainage sclerotomies were created in the quadrants of the involved SCH, confirmed by ultrasonography. In all treated patients reattachment of the choroid was obtained. The visual acuity improved significantly (final v. a. was between 0. 02 and 0. 5).

CONCLUSIONS

According to our observation, the implementation of the suprachoroidal drainage combined with vitrectomy might improve the prognosis and facilitate the achievement of functional vision.

摘要

目的

脉络膜上腔出血(SCH)是手术期间发生的一种罕见并发症(早期SCH),或在术后3 - 5天作为迟发性脉络膜上腔出血出现。它更常发生于白内障手术合并玻璃体丢失或晶状体脱位的患者。本研究的目的是介绍7例因白内障手术导致脉络膜上腔出血患者的手术治疗情况。

材料与方法

患者的平均年龄为72.4岁。其中女性3例,男性4例。6例患者采用超声乳化手术,1例采用囊外白内障摘除术。3例患者在手术过程中发生了玻璃体丢失和晶状体脱位。

结果

4例患者进行了脉络膜上腔引流。3例患者在脉络膜上腔引流后进行了玻璃体切除术。该组中有2例患者注入了硅油。所有病例均使用前房灌注管。通过超声检查确定受累脉络膜上腔出血的象限,在这些象限进行引流巩膜切开术。所有接受治疗的患者脉络膜均实现了复位。视力显著提高(最终视力在0.02至0.5之间)。

结论

根据我们的观察,实施脉络膜上腔引流联合玻璃体切除术可能会改善预后并有助于获得功能性视力。

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