背景:本文的主要目的是介绍一种可以精确定位晶状体后囊的方法,以利于相对完整地切除前玻璃体。
方法:试验组和对照组共51例。所有病例均进行超声乳化联合玻璃体切除术。对照组完成白内障手术后,外科医生用手术眼进行了常规的前路玻璃体切除术。在实验组中,根据晶状体后囊的弯曲波纹进行前路玻璃体切除术。在操作过程中,在曲安奈德的帮助下,行玻璃体前皮质切除;1周时记录所有患者的最佳矫正视力和眼压,术后1个月和3个月。
结果:50例患者行超声乳化联合玻璃体切除术,除了实验组的一名患者失去了随访。手术后,除对照组2例患者眼压暂时升高外,所有患者均未出现明显并发症.两组术前视力差异无统计学意义(t=0.83,P=0.25)。两组在1周时最佳矫正视力均有不同程度的改善,术后1个月和3个月。此外,两组在3个随访时间点的BCVA差异无统计学意义(t=-1.15,-1.65,-1.09,P=0.53,0.21,0.23)。手术后,除对照组2例患者眼压暂时升高外,所有患者均未出现明显并发症.观察到玻璃体前皮质不完全切除,每组2例,差异无统计学意义(χ2=7.81,P>0.05)。
结论:在白内障手术联合玻璃体切割的过程中,在晶状体后囊内出现的波纹是其局部化的一个重要标志。在线状波纹的帮助下,可以安全有效地完成前玻璃体切除术,手术效果与传统手术几乎相同。特别适合玻璃体手术的初学者。
BACKGROUND: The main purpose of this paper is to introduce a method that can accurately locate the posterior capsule of the lens to facilitate a relatively complete resection of the anterior vitreous body.
METHODS: A total of 51 patients in the experimental group and control group were enrolled in this study. Phacoemulsification combined with vitrectomy was performed in all cases. After the cataract procedure was completed in the control group, the surgeon performed a conventional anterior vitrectomy with the operative eye. In the experimental group, anterior vitrectomy was performed according to the threadiness corrugation of the posterior capsule of the lens. During the operation, with the help of triamcinolone, two surgeons confirmed the resection of the anterior vitreous cortex; the best corrected visual acuity and intraocular pressure of all patients were recorded at 1 week, 1 month and 3 months after surgery.
RESULTS: Fifty patients underwent phacoemulsification combined with vitrectomy, except one patient in the experimental group who was lost to follow-up. After surgery, no significant complications were observed in all patients except two patients in the control group with temporary increases in intraocular pressure. There was no significant difference in preoperative visual acuity between the two groups (t = 0.83, P = 0.25). Both groups had varying degrees of improvement in best corrected visual acuity at 1 week, 1 month and 3 months after surgery. Moreover, there was no significant difference in BCVA between the two groups at the three follow-up time points (t=-1.15, -1.65, -1.09, P = 0.53, 0.21, 0.23). After surgery, no significant complications were observed in all patients except two patients in the control group with temporary increases in intraocular pressure. Incomplete resection of the anterior vitreous cortex was observed in 2 patients in each group, but there was no significant difference (χ2 = 7.81, P > 0.05).
CONCLUSIONS: In the process of cataract surgery combined with vitrectomy, thready corrugation appears in the posterior capsule of the lens and is an important sign of its localization. Anterior vitrectomy can be accomplished safely and effectively with the help of thread-like corrugation, and the surgical effect is almost the same as that of traditional surgery. Especially suitable for beginners in vitreous surgery.