不同手術(shù)方式治療硅油填充眼并發(fā)性白內(nèi)障的療效觀察

陳　曦，謝　平，陳雪娟

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·臨床研究·

不同手術(shù)方式治療硅油填充眼并發(fā)性白內(nèi)障的療效觀察

陳曦，謝平，陳雪娟

?METHODS: The data of 75 eyes of 75 patients with cataract induced by silicone oil-filled eye were reviewed. Those patients were divided into group A, B, C. The patients in group A were treated by phacoemulsification combined with silicone oil removal through pupil and IOL implantation, the patients in group B were treated by phacoemulsification combined with silicone oil removal through 23G vitrectomy system and IOL implantation, the patients in group C were treated by phacoemulsification combined with silicone oil removal through 20G vitrectomy system and IOL implantation. The operation time, intraocular pressure, best corrected visual acuity (BCVA), discomfort days and complications before and after the surgery were compared.

?RESULTS: The differences of the intraocular pressure were not statistically significant between the three groups after the surgery. The BCVA of the three groups were all improved, but the differences were not statistically significant between three groups. The differences in postoperative complications showed no statistically significant. Otherwise, group A and B cost less operation time. The discomfort days of group A were less than other groups.

?CONCLUSION: Three different surgical methods were safe and effective, appropriate surgical approach could be chosen according to the patients’ clinical manifestations. For patients with cataract induced by silicone oil-filled eye whose retina recovered well, phacoemulsification combined with silicone oil removal through pupil and IOL implantation is a time-saving, safe and effective method.

目的：比較三種手術(shù)方式治療硅油填充眼并發(fā)性白內(nèi)障的臨床療效。

方法：回顧性分析75例75眼硅油填充眼并發(fā)性白內(nèi)障患者，分成三組，A組采取經(jīng)瞳孔區(qū)硅油取出聯(lián)合白內(nèi)障超聲乳化摘除及IOL植入術(shù)，B組采取23G玻璃體切除系統(tǒng)經(jīng)睫狀體扁平部硅油取出聯(lián)合白內(nèi)障超聲乳化摘除及IOL植入術(shù)，C組采取20G玻璃體切除系統(tǒng)經(jīng)睫狀體扁平部切口硅油取出聯(lián)合白內(nèi)障超聲乳化摘除及IOL植入術(shù)。比較三組手術(shù)時間、術(shù)前術(shù)后眼壓和最佳矯正視力、術(shù)后眼部刺激癥狀時間、并發(fā)癥的發(fā)生情況。

結(jié)果：三組術(shù)眼術(shù)后眼壓組間比較無統(tǒng)計學(xué)差異，術(shù)后視力較術(shù)前均有所提高，組間比較無統(tǒng)計學(xué)差異，并發(fā)癥三組也沒有差異；但是A組和B組較C組所需手術(shù)時間更短；在術(shù)后眼部刺激癥狀時間上，A組較B組和C組更短。

結(jié)論：三組手術(shù)方式均安全有效，應(yīng)根據(jù)患者病情選擇適合的手術(shù)方式，對于術(shù)前明確眼底情況恢復(fù)良好的硅油填充眼并發(fā)性白內(nèi)障，經(jīng)瞳孔區(qū)硅油取出聯(lián)合白內(nèi)障超聲乳化及IOL植入術(shù)是一種快速安全有效的聯(lián)合手術(shù)方式。

白內(nèi)障；硅油填充眼；超聲乳化；硅油取出；20G；23G

引用：陳曦，謝平，陳雪娟.不同手術(shù)方式治療硅油填充眼并發(fā)性白內(nèi)障的療效觀察.國際眼科雜志2016;16(11):2063-2066

0　引言

自硅油被作為玻璃體腔填充物以來，被廣泛應(yīng)用于玻璃體視網(wǎng)膜手術(shù)中，為復(fù)雜性玻璃體視網(wǎng)膜手術(shù)的成功提供了保障[1]。……