协和医学杂志

2015, v.6(01) 38-41

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高速玻璃体切割系统在眼前后节联合手术中的应用
Application of High-speed Vitrectomy System in Combined Surgery of Anterior and Posterior Segments of the Eye

夏建平;崔明月;祁媛媛;陈丽娜;李胜;董方田;
XIA Jian-ping;CUI Ming-yue;QI Yuan-yuan;CHEN Li-na;LI Sheng;DONG Fang-tian;Department of Ophthalmology,the Third People's Hospital of Dalian;Department of Ophthalmology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;

摘要(Abstract):

目的观察高速玻璃体切割系统在白内障超声乳化手术联合后段玻璃体切割手术中的应用效果。方法 2012年10月至2013年3月收治的60岁以上且有Ⅱ级以上晶状体浑浊伴玻璃体视网膜疾病患者81例(86眼),采用高速玻璃体切割系统行前后节联合手术。其中男性43例(46眼),女性38例(40眼),平均年龄(72.1±10.5)岁(60~83岁)。患者术前均行眼科常规检查、A/B超声检查及人工晶体度数测定。患者行23G微创切口穿刺后,先闭合眼内灌注,行白内障超声乳化及人工晶体植入术,保留前房粘弹剂,行Resight非接触式广角镜系统下高速玻璃体切割,术后行硅油或C3F8或眼内灌注液填充。观察患者视力改善状况、眼底情况及手术后并发症发生的情况。结果所有患者顺利完成手术,平均手术时间(48.0±12.6)min(35~65 min)。86只眼中,术后视力提高者80只眼(93.0%),不变者5只眼(5.8%),视力下降者1只眼(1.2%)。术后角膜水肿者10只眼(11.6%),前房反应25只眼(29.1%),经对症处理1周后均明显缓解。无其他并发症发生。结论对于有Ⅱ级以上晶状体浑浊且需要行玻璃体切割手术的老年白内障患者,釆用高速玻璃体切割并联合超声乳化人工晶体植入,可在术后快速提高视力,且较少发生并发症。
Objective To observe the application of high-speed vitrectomy system in combined surgery of phacoemulsification and vitrectomy. Methods Eighty-one patients( 86 eyes) aged over 60 years with degree Ⅱlens opacity and vitreous retinal disorders treated between October 2012 and March 2013 were enrolled. The patients included 43 males( 46 eyes) and 38 females( 40 eyes),at a mean age of( 72. 1 ± 10. 5) years( 60- 83years). All the patients received routine ophthalmological examination,A / B mode ultrasound,and intraocular lens degree testing. With a 23 G minimally invasive incision,phacoemulsification and intraocular lens implantation were performed after closed the intraocular perfusion. With the viscoelastic agent left in the anterior chamber,high-speed vitrectomy was conducted using Resight noncontact wide-angle lens system,finished by filling with silicone oil,C3F8,or intraocular infusion fluid. Visual acuity,fundus condition,and postoperative complications of the patients were observed. Results The combined surgery was successfully performed in all the pa-tients,with a mean operation time of( 48. 0 ± 12. 6) minutes( 35- 65 minutes). Among the 86 eyes,vision was improved in 80 eyes( 93. 0%),unchanged in 5 eyes( 5. 8%),and deteriorated in 1 eye( 1. 2%). After the surgery,10 eyes( 11. 6%) developed corneal edema,and 25( 29. 1%) showed anterior chamber reaction,all mitigated by treatment after 1 week. No other complications were reported. Conclusions For the elderly patients with degree II lens opacity and the need of vitrectomy,the high-speed vitrectomy combined with phacoemulsification and intraocular lens implantation can rapidly improve eyesight and reduce the incidence of postoperative complications.

关键词(KeyWords): 高速玻璃体切割;眼前后节联合手术
high-speed vitrectomy;combined surgery of anterior and posterior segments of the eye

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作者(Author): 夏建平;崔明月;祁媛媛;陈丽娜;李胜;董方田;
XIA Jian-ping;CUI Ming-yue;QI Yuan-yuan;CHEN Li-na;LI Sheng;DONG Fang-tian;Department of Ophthalmology,the Third People's Hospital of Dalian;Department of Ophthalmology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;

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