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目的探讨小切口非超声乳化白内障摘除术后角膜水肿的原因及处理。方法观察286例(305眼)小切口非超声乳化白内障摘除术患者,术后1 d、7 d、1个月角膜水肿情况,分析其原因并归类。结果术后第一天角膜水肿189眼(61.97%),术后第7天角膜水肿48眼(15.74%),术后1个月角膜水肿1眼(0.32%)。引起角膜水肿的原因有:内切口太靠前138眼(73.02%)、年龄65岁以上者占110只眼(58.20%)、灌注压太大,操作时间太长25眼(13.23%)、术中后弹力层撕脱3眼(1.59%)、术后眼压升高9眼(4.76%)等。结论小切口非超声乳化白内障摘除术后角膜水肿的原因有:年龄较大;切口靠前、核较硬、较大娩核困难;灌注压力过高,抽吸时间过长;术前角膜已有损伤;术中后弹力层撕脱;术后暂时性高眼压等。抗炎、增加角膜营养可促进角膜水肿吸收。
Objective To investigate the causes and management of corneal edema after small incision non-phacoemulsification cataract extraction. Methods 286 eyes (305 eyes) with small incision non-phacoemulsification cataract extraction and corneal edema at 1, 7 and 1 month after operation were observed and analyzed. Results On the first postoperative day, corneal edema was observed in 189 eyes (61.97%), corneal edema in 48 eyes (15.74%) on day 7 postoperatively, and corneal edema was observed in 1 month (0.32%). The causes of corneal edema were as follows: 138 eyes (73.02%) were too advanced in the incision, 110 eyes (58.20%) were over 65 years old, the perfusion pressure was too large, the operating time was too long for 25 eyes (13.23%), The middle and posterior elastic layer avulsion 3 eyes (1.59%), postoperative intraocular pressure increased 9 eyes (4.76%) and so on. Conclusions The reasons of corneal edema after small incision non-phacoemulsification cataract surgery are as follows: older age, incision anteriorly, hard nucleus, larger nucleus obstruction, high perfusion pressure, long suction time, preoperative corneal Injury; avulsion after surgery avulsion; transient intraocular hypertension and so on. Anti-inflammatory, increased corneal nutrition can promote corneal edema absorption.