Sun I-Ting, Lee Tsung-Han, Chen Chih-Hsin
Department of Ophthalmology, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan.
Department of Ophthalmology, Chang Gung Memorial Hospital Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Case Rep Ophthalmol. 2017 May 29;8(2):321-325. doi: 10.1159/000477159. eCollection 2017 May-Aug.
We report a case of rapid cataract progression after Nd:YAG vitreolysis for vitreous floaters.
A 55-year-old man presented with acute onset of blurred vision following Nd:YAG vitreolysis for symptomatic floaters in the left eye. His initial best corrected visual acuity (BCVA) was 20/1,000 in the left eye. Ocular examinations showed frost-like opacities of the lens and a suspected break of the posterior capsule in the left eye. There were no detectable retinal lesions. Cataract surgery was then arranged. Posterior capsular rupture and vitreous loss occurred during surgery, which required a subsequent pars plana vitrectomy. After the surgery, BCVA in the left eye gradually improved to 20/20 and was maintained during a 1-year follow-up period.
Crystalline lens injuries and rapid cataract progression may occur following Nd:YAG vitreolysis. While dealing with this type of complicated cataract, clinicians should be aware of the possibility of posterior lens capsule rupture during surgery and the need for combined vitrectomy.
我们报告一例在钕:钇铝石榴石激光玻璃体溶解术治疗玻璃体混浊后白内障快速进展的病例。
一名55岁男性，因左眼有症状的玻璃体混浊接受钕:钇铝石榴石激光玻璃体溶解术后，出现急性视力模糊。其左眼最初的最佳矫正视力（BCVA）为20/1000。眼部检查显示左眼晶状体有霜样混浊，怀疑后囊膜破裂。未发现视网膜病变。随后安排了白内障手术。手术过程中发生了后囊膜破裂和玻璃体丢失，这需要随后进行玻璃体切除术。手术后，左眼的BCVA逐渐提高到20/20，并在1年的随访期内保持稳定。
钕:钇铝石榴石激光玻璃体溶解术后可能发生晶状体损伤和白内障快速进展。在处理这类复杂白内障时，临床医生应意识到手术中晶状体后囊膜破裂的可能性以及联合玻璃体切除术的必要性。
