Swan K C, Lindgren T W
Trans Am Ophthalmol Soc. 1980;78:55-69.
In 1891, Priestly Smith wrote that in glaucoma surgery, "the lens is occasionally wounded, unsuspected by the operator," and described serious consequences. In 1953 Christensen and McLean found histologic evidence of perforation of the lens capsule in many eyes which had been enucleated after unsuccessful glaucoma surgery. Twelve additional enucleated eyes with lens perforations plus clinical consultations indicate that unintentional surgical injuries to the lens still are occurring during iridectomies, filtrations, and trabeculectomies and usually are unsuspected by the surgeon. This injury should be considered when a lens opacity becomes manifest within a few days or weeks after surgery. In addition to failure of the operation, the consequences vary from limited cataract formation to complete opacification and subluxation of the lens. The lens injury also may cause a severe phacogenic uveitis which requires early lens extraction to avoid extensive intraocular fibroplasia. Clinical features and histopathology are presented with illustrative cases. The prevention and management of unintentional lens injury are discussed.
1891年，普里斯特利·史密斯写道，在青光眼手术中，“晶状体偶尔会受到损伤，手术者并未察觉”，并描述了其严重后果。1953年，克里斯蒂安森和麦克林在许多青光眼手术失败后被摘除的眼球中发现了晶状体囊膜穿孔的组织学证据。另外12只伴有晶状体穿孔的摘除眼球以及临床会诊表明，在虹膜切除术、滤过术和小梁切除术中，晶状体仍会意外受到手术损伤，而外科医生通常并未察觉。当术后几天或几周内晶状体出现混浊时，应考虑到这种损伤。除了手术失败外，其后果从局限性白内障形成到晶状体完全混浊和半脱位不等。晶状体损伤还可能引发严重的晶状体源性葡萄膜炎，这需要尽早摘除晶状体以避免广泛的眼内纤维增生。文中通过实例介绍了临床特征和组织病理学情况，并讨论了意外晶状体损伤的预防和处理方法。
