Zafar Shakir, Kamil Zeeshan, Bokhari Syeda Aisha, Shakir Munira
Department of Ophthalmology, LRBT Free Base Eye Hospital, Karachi.
J Coll Physicians Surg Pak. 2012 Jun;22(6):367-70.
To determine the visual outcome of patients who underwent pars plana vitrectomy for dropped nucleus after phacoemulsification.
Interventional case series.
LRBT Free Base Eye Hospital, Karachi, from February 2008 to January 2011.
Forty-eight eyes of forty eight patients having history of dropped nucleus (soft remnant, half nucleus or complete nucleus) underwent 20 gauge pars plana vitrectomy within 24 days of phacoemulsification. After complete vitrectomy nucleus was lifted with the help of perfluorocarbon and removed either through a limbal incision or by using phacofragmenter, whereas small lens remnants were removed with a vitreous cutter. Intraocular lens was implanted at the end of surgery. Postoperative visual acuity, and any complications were assessed. Patients were followed for a period of 12 months.
Final visual acuity ranged from 6/9 to 6/18 in 34 eyes (70.83%), 6/24 to 6/36 in 8 eyes (16.66%) and 6/60 or less in 6 of 48 eyes (12.5%). Complications included raised intraocular pressure in 6 eyes (12.5%) and retinal detachment in 2 eyes (4.1%), corneal oedema and decompensation in 3 eyes (6.25%) and cystoids macular oedema in 4 cases (8.33%) out of 48 cases.
The loss of crystalline lens in the vitreous during phacoemulsification is a severe complication, but appropriate and timely management can restore good visual outcome and minimize complications.
确定接受超声乳化白内障吸除术后晶状体核坠入玻璃体腔而行玻璃体切割术患者的视力预后。
干预性病例系列研究。
2008年2月至2011年1月，卡拉奇LRBT免费基础眼科医院。
48例有晶状体核坠入玻璃体腔（软核残余、半核或完整核）病史的患者的48只眼，在超声乳化白内障吸除术后24天内接受了20G玻璃体切割术。完全玻璃体切除术后，借助全氟碳化合物托起晶状体核，通过角膜缘切口或使用晶状体粉碎器将其取出，而小的晶状体残余物则用玻璃体切割器取出。手术结束时植入人工晶状体。评估术后视力及任何并发症。对患者进行为期12个月的随访。
34只眼（70.83%）的最终视力在6/9至6/18之间，8只眼（16.66%）在6/24至6/36之间，48只眼中的6只眼（12.5%）在6/60或更低。并发症包括6只眼（12.5%）眼压升高、2只眼（4.1%）视网膜脱离、3只眼（6.25%）角膜水肿和失代偿以及48例中的4例（8.33%）黄斑囊样水肿。
超声乳化白内障吸除术中晶状体核坠入玻璃体腔是一种严重并发症，但适当及时的处理可恢复良好的视力预后并减少并发症。
