Lam D S, Tham C C, Kwok A K, Gopal L
Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, N.T.
Eye (Lond). 1998;12 ( Pt 3a):395-8. doi: 10.1038/eye.1998.93.
Small-incision cataract extraction by phacoemulsification through an anterior continuous circular capsulorhexis, pars plana vitrectomy, forceps removal of intraocular foreign body (IOFB) and primary intraocular lens implantation were performed in 4 eyes (4 patients) with IOFB and traumatic cataract, as an emergency combined procedure.
At a mean follow-up of 12.3 months (range 7-19 months) the best corrected visual acuity of the 4 eyes ranged from 6/6 to 6/12. The only complication encountered in our series was an opacified posterior capsule that developed 10 months post-operatively in one case. This was easily dealt with by neodymium:YAG laser capsulotomy, with good final visual outcome.
The results of combined one-stage instead of sequential surgeries, and phacoemulsification instead of lensectomy or extracapsular cataract extraction for patients with IOFB and cataract are encouraging. It could be a good option in selected cases. However, the safety and efficacy of this combined procedure need to be evaluated further by a larger-scale, longer follow-up study.
对4例眼内异物(IOFB)合并外伤性白内障患者的4只眼,作为急诊联合手术,行经前连续环形撕囊的小切口白内障超声乳化吸出术、经平坦部玻璃体切除术、用镊子取出眼内异物及一期人工晶状体植入术。
平均随访12.3个月(范围7 - 19个月),4只眼的最佳矫正视力在6/6至6/12之间。本系列中唯一遇到的并发症是1例术后10个月出现后囊膜混浊。通过钕:钇铝石榴石激光囊膜切开术很容易处理,最终视力结果良好。
对于眼内异物合并白内障患者,采用一期联合手术而非分期手术,以及采用超声乳化吸出术而非晶状体切除术或白内障囊外摘除术的结果令人鼓舞。在某些选定病例中它可能是一个不错的选择。然而,这种联合手术的安全性和有效性需要通过更大规模、更长时间的随访研究进一步评估。