小切口手法碎核白内障摘除术治疗白内障合并高度近视_临床医学论文.docVIP

小切口手法碎核白内障摘除术治疗白内障合并高度近视_临床医学论文 小切口手法碎核白内障摘除术治疗白内障合并高度近视_临床医学论文 【摘要】 　　目的：观察小切口手法碎核白内障摘除术治疗白内障合并高度近视的临床效果和安全性。方法：对61例78眼采用小切口手法碎核白内障摘除术联合低度数大直径人工晶状体植入术，观察术后视力，屈光状态及手术并发症。术后随访6～24mo。结果：78眼均成功植入人工晶状体，视力都有不同程度的提高，术后3mo时最佳矫正视力lt;0.1者2眼，0.1～0.4者26眼，gt;0.4者50眼；大部分患者残留低度的近视屈光状态;后囊膜混浊12眼;术中未发生前囊膜撕裂和后囊膜破裂等并发症；无视网膜脱离和黄斑囊样水肿的发生。结论：小切口手法碎核白内障摘除术联合低度数大直径人工晶状体植入术治疗白内障合并高度近视，具有临床效果佳、手术安全性高及并发症少的优点，在经济条件相对落后的地区，值得推广应用。 【关键词】 小切口;白内障;高度近视 　　Abstractgh myopia. METHODS: A total of 78 eyes of 61 patients received manual small incision cataract surgery with lowdegree and largediameter intraocular lens implantation. The postoperative visual acuity, refractive status, and surgical complications were observed. Patients were followed up 6 to 24 months after operation. RESULTS: A total of 78 eyes were successfully implanted in intraocular lens. Their visual acuity improved to varied degrees. The best corrected visual acuity of 2 eyes werelt;0.1 at 3 months after operation, twentysix eyes were between 0.1 and 0.4, fifty eyes weregt;0.4. The majority of patients remained a low degree of residual myopia refractive state. Twelve eyes suffered from posterior capsular opacification. Anterior capsule tear and posterior capsule rupture or other complications did not happen during surgery. There was no retinal detachment or cystoid macular edema.CONCLUSION: Manual small incision cataract surgery with lowdegree and largediameter intraocular lens implantation has advantages such as good clinical effect, high operative security and fewer complications. In the regions where economic conditions are relatively backward, it is worthy of popularization. 　　KEYWORDS:small incision; cataract; high myopia 　　0引言 随着现代显微手术技术的发展和改进，小切口非超声乳化白内障摘除术以术后反应轻、愈合快、散光小、视力恢复迅速稳定等优点成为现代白内障手术的发展趋势之一。由于高度近视眼在解剖学和病理学上的特殊性:眼轴长、晶状体悬韧带松弛、脆弱,存在玻璃体液化、变性和后脱离等病理改变，其白内障手术难度大，并发症发生率相对也较高。我院自2005年开始采用小切口手法碎核白内障摘除及低度数大直径人工晶状体植入术治疗白内障合并高度近视眼，取得良好效果，现将结果报告如下。 　　1对象和方法 　　1.1对象 　　收集2005在我院就诊的白内障合并高度近视患者61例78眼，男27例35眼，女34例43眼；年龄49～81（平