Wan Wenjuan, Hu Ke, Ji Yan, Li Can
The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, Chongqing 400016, China.
Case Rep Ophthalmol Med. 2017;2017:4230657. doi: 10.1155/2017/4230657. Epub 2017 Jul 18.
To investigate the optimal strategy for surgical management of traumatic cataract with posterior capsular rupture.
We describe four cases of traumatic cataract with posterior capsular rupture and an in vitro model built to evaluate the optimal infusion pressure during surgery.
All patients underwent cataract surgery. By using an anterior chamber maintainer to elevate infusion pressure, we safely performed cataract extraction without phacoemulsification. At 3 days after surgery, visual acuity was greater than 20/25 in all patients, without any complications. Phacoemulsification would also be feasible under anterior chamber maintainer infusion in a similar case of traumatic cataract with posterior capsular rupture during intravitreal injection. In addition, an in vitro model that we established using pig's eyes revealed that the anterior chamber remained stable when the height of infusion bottle was 50-90 mmHg, whereas shallowing of the anterior chamber occurred when the height of infusion bottle was reduced to 40 mmHg, and corneal edema occurred when the height of infusion bottle was raised to 100 mmHg.
During management of traumatic cataract with posterior capsular rupture, using an anterior chamber maintainer to maintain optimal infusion pressure may reduce the risk of anterior hyaloid membrane breakup and vitreous loss.
探讨外伤性白内障合并后囊膜破裂的手术治疗最佳策略。
我们描述了4例外伤性白内障合并后囊膜破裂的病例，并建立了一个体外模型来评估手术期间的最佳灌注压力。
所有患者均接受了白内障手术。通过使用前房维持器提高灌注压力，我们安全地完成了白内障摘除术，未进行超声乳化。术后3天，所有患者视力均大于20/25，无任何并发症。在类似的外伤性白内障合并后囊膜破裂且术中进行玻璃体注射的病例中，在前房维持器灌注下进行超声乳化也是可行的。此外，我们用猪眼建立的体外模型显示，当灌注瓶高度为50 - 90 mmHg时，前房保持稳定；当灌注瓶高度降至40 mmHg时，前房变浅；当灌注瓶高度升至100 mmHg时，角膜水肿。
在外伤性白内障合并后囊膜破裂的治疗中，使用前房维持器维持最佳灌注压力可降低前玻璃体膜破裂和玻璃体丢失的风险。
