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透明角膜玻璃体切除术联合超声乳化白内障吸除术及折叠式人工晶状体植入术。

Clear corneal vitrectomy combined with phacoemulsification and foldable intraocular lens implantation.

机构信息

Department of Ophthalmology, Nagoya University Hospital, Nagoya, Japan; Department of Ophthalmology, Toyama Prefectural Central Hospital, Toyama, Japan; Department of Ophthalmology, Wilmer Eye Institute, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA.

出版信息

Clin Exp Ophthalmol. 2014 Jul;42(5):452-8. doi: 10.1111/ceo.12236. Epub 2013 Oct 28.

Abstract

BACKGROUND

We have developed a technique for the treatment of cataract and epiretinal membrane using a 25-gauge vitrectomy system through corneal ports.

DESIGN

Randomized, prospective study, Toyama Prefectural Central Hospital, Toyama, Japan.

PARTICIPANTS

Twenty eyes of equal patients scheduled for cataract surgery combined with vitrectomy.

METHODS

Twenty eyes with cataract and epiretinal membrane were received treatment with our newly developed system (clear corneal vitrectomy) or the standard 25-gauge pars plana vitrectomy with corneal incision cataract surgery. The newly developed system uses 0.5-mm wide corneal side ports located at the superonasal, superotemporal and inferotemporal positions. After phacoemulsification using corneal incision, an infusion cannula was inserted from the inferotemporal port. Then core 25-gauge vitrectomy was performed using the corneal three port. After the epiretinal membrane was removed using forceps, an intraocular lens was implanted into the capsular bag. Finally, all corneal incision wounds were hydrated.

MAIN OUTCOME MEASUREMENT

Visual acuity, intraocular pressure, corneal thickness, corneal endothelial cell and ocular inflammation were examined.

RESULTS

All procedures were uncomplicated in both groups. There was no leakage of aqueous humour from the corneal wounds in the developed system. There were no significant differences in visual acuity, corneal thickness and endothelial cell density loss.

CONCLUSIONS

Clear corneal vitrectomy would be a good option for selected cases with cataract and vitreoretinal diseases.

摘要

背景

我们已经开发出一种使用 25G 玻璃体切割系统通过角膜口治疗白内障和视网膜前膜的技术。

设计

随机、前瞻性研究,日本富山县中央医院。

参与者

20 名接受白内障手术联合玻璃体切除术的同质患者的 20 只眼。

方法

20 只白内障合并视网膜前膜的眼接受我们新开发的系统(透明角膜玻璃体切除术)或标准的 25G 经角膜切口的巩膜切除术联合角膜切口白内障手术治疗。新开发的系统使用位于超鼻上、超颞和下颞位置的 0.5 毫米宽的角膜侧口。经角膜切口行超声乳化白内障吸除术后,从下颞侧口插入灌注套管。然后使用角膜三切口进行核心 25G 玻璃体切割术。用镊子取出视网膜前膜后,将人工晶状体植入囊袋内。最后,所有角膜切口伤口均水化。

主要观察指标

视力、眼压、角膜厚度、角膜内皮细胞和眼内炎症。

结果

两组手术均无并发症。新系统中角膜伤口无房水漏出。视力、角膜厚度和内皮细胞密度损失无显著差异。

结论

对于合并白内障和玻璃体视网膜疾病的特定病例,透明角膜玻璃体切除术是一种很好的选择。

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