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目的 评价特发性黄斑裂孔玻璃体切除术后并发性白内障的超声乳化人工晶体植入术的临床疗效。方法 回顾性分析对 3 2例 ( 3 2眼 )特发性黄斑裂孔玻璃体切除术后并发性白内障患者采用白内障超声乳化人工晶体植入术 :2 1例 ( 2 1眼 )行巩膜隧道切口超声乳化术 ,11例 ( 11眼 )行透明角膜切口超声乳化术 ,观察术中、术后并发症及患眼视力、黄斑变化情况。结果 术后三月 ,所有患眼视力均有不同程度的提高 ,最佳矫正视力 0 0 1～ 0 1共 4眼 ,0 1～ 0 3共 11眼 ,0 3～ 1 0共17眼 ,术后早期并发症为角膜水肿 2眼 ,术后远期并发症为后发性白内障 6眼 ,需Nd :YAG激光治疗 ,黄斑裂孔重新裂开 1眼。结论 对于特发性黄斑裂孔玻璃体切除术后并发性白内障 ,超声乳化人工晶体植入术操作安全、临床效果好、术后并发症轻微 ,是目前最为理想的治疗方法。
Objective To evaluate the clinical efficacy of phacoemulsification and intraocular lens implantation in patients with idiopathic macular hole after vitrectomy. Methods Retrospective analysis of 32 cases (32 eyes) of idiopathic macular hole after vitrectomy cataract patients with cataract phacoemulsification with intraocular lens implantation: 21 cases (21 eyes) scleral tunnel incision phacoemulsification And 11 cases (11 eyes) underwent phacoemulsification with clear corneal incision. The intraoperative and postoperative complication and visual acuity and macular degeneration were observed. Results All eyes had improvement of visual acuity in 3 months after surgery. The best corrected visual acuity was 4 0 0 1 ~ 0 1, 11 eyes 0 1 ~ 0 3, 17 eyes 0 3 ~ 1 0 The early postoperative complications were corneal edema in 2 eyes and postoperative long-term complications in 6 eyes with posterior capsular cataract. Nd: YAG laser treatment was needed and the macular hole was reopened in 1 eye. Conclusions For cataract patients with idiopathic macular hole after vitrectomy, phacoemulsification and intraocular lens implantation are safe, with good clinical effect and minimal postoperative complications. It is the most ideal method for the treatment of idiopathic macular hole.