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目的 :报告Kelman晶体乳化白内障吸出术 (Kelman’sphacoemulsificationcataractextraction ,KPE)中晶体核脱入玻璃体腔的发病率、临床表现和处理方法。方法 :回顾我院 1 996年 5月～ 1 998年 6月间 4 40 0例中KPE手术中晶体核脱入玻璃体 1 0例病人的临床表现及处理方法。结果 :晶体核掉入玻璃体发生率为 0 2 3 %。掉核后发生高眼压者 1 0 0 % ;掉核≤ 1 /4、KPE手术Ⅰ期植入前房型人工晶体(AC IOL) 3例 ,术后视力均≥ 0 5;掉核后 2周内实施玻璃体切割手术 4例 ;玻璃体切割术后植入AC IO L2例 ,术后矫正视力均≥ 0 4 ;掉核≥ 1 /2、未经玻璃体切割术取核者 3例 ,术后视力均低于 0 0 1。结论 :掉核≤ 1 /4可Ⅰ期植入前房型人工晶体 ,不需手术治疗亦能获得较好的视力 ;掉核≥ 1 /2 ,必须经玻璃体切割术取核 ,否则 ,视力预后极差 ;通过玻璃体切割手术取核 ,可以使大多数病人最终获得良好的视力 ,而且是处理此种并发症唯一正确的方法。
OBJECTIVE: To report the incidence, clinical presentation and management of intraocular lens detachment in Kelman’s phacoemulsification cataract extraction (KPE). Methods: The clinical manifestations and treatment of 10 cases of vitreous detachment in 4 40 0 cases during KPE operation from May 1996 to June 1998 in our hospital were retrospectively reviewed. Results: The incidence of crystal nucleus dropped into the vitreous body was 102.3%. Three cases of anterior chamber intraocular lens (IOL) were implanted in KPE surgery stage Ⅰ after operation, the visual acuity was ≥ 0 5 after 2 weeks of exfoliation Four cases of vitrectomy were performed in vitrectomy; L2 cases of AC IO were implanted after vitrectomy, the corrected visual acuity was ≥0 4; the nucleus removed ≥1 / 2, the cases without vitrectomy were visual acuity Below 0 0 1. CONCLUSION: Falling nuclei ≤1 / 4 can be implanted into anterior chamber intraocular lens in stage Ⅰ, and can obtain better visual acuity without surgical treatment. If the nucleus diameter ≥1 / 2, it must be taken by vitrectomy, otherwise, the visual acuity pole Poor; taking vitrectomy through the vitrectomy can give most patients ultimate good eyesight and is the only correct way to deal with such complications.