| [摘要] 目的：研究前部玻璃体切割在复杂前节手术中的作用。方法：回顾性研究应用前部玻璃体切割术处理复杂前节手术并发症151例（151眼），其中白内障超声乳化术中出现后囊破裂、玻璃体外溢62例，儿童后发性白内障16例，眼前段外伤伴玻璃体脱出73例。均经角巩膜缘隧道切口行前部玻璃体切割，手术后定期复查患眼视力、最佳矫正视力，前节反应情况与人工晶体位置，玻璃体视网膜情况。结果：62眼超声乳化术中后囊破裂经前部玻璃体切割处理均Ⅰ期植入后房型人工晶状体，最佳视力0.3~0.5者19例（30.64%，19/62），0.5~0.8者32例（51.61%，32/62），0.8以上11例（11/62，17.78%），16眼儿童后发性白内障经前部玻璃体切割处理11（11/16，68.75%）例视力提高，4例后发障复发（4/16， 25%）。前部玻璃体切割处理外伤性白内障，伴后囊破裂54例，49例（49/54，90.74%）植入人工晶状体，最佳视力0.1以下者3例（3/49，5.56%），0.1~0.3者6例（6/49，11.12%），0.3~0.5者17例（17/49，31.48%），0.5~0.8者15例（15/49，27.59%），0.8以上者8例（8/49，14.81%），伴中、重度晶状体脱位13例，均植入人工晶状体，视力0.1以下者2例（2/13，15.38%），0.1~0.3者3例（3/13，23.08%），0.3~0.8者7例（7/13，53.84%），0.8以上者1例（1/13，7.69%）。结论：前部玻璃体切割手术在处理复杂的前节手术及并发症方面具有一定的优越性。
关键词：前部玻璃体切割术 眼前节 白内障 人工晶状体
[Abstract] Objective: To study the useful of anterior vitrectomy in the complicated anterior segmental operation. Methods: The useful of anterior vitrectomy in dealing with the complication of anterior segment surgery of 151 eyes was studied retrospectively. Of them 62 eyes happened with posterior capsule rupture (PCR) and vitreous prolapsed during the PHACO operation; 16 children eyes had the secondary cataract after the operation; 73 eyes had complicated cataract with vitreous prolapsed in penetrating injury. All 151 eyes were operated on the anterior vitrectomy through the limbal incision. The visual acuity, best corrected visual acuity (BCVA), the position of IOL and status of retina were examined routinely after the surgery. Results: All the 62 eyes that happened with posterior capsule rupture (PCR) and vitreous prolapsed during the PHACO operation were implanted the posterior IOLs primarily. 19 eyes (30.64%) had the BCVA 0.3—0.5, 32 eyes the BCVA 0.5—0.8 (51.61%) and 11 eyes had the BCVA more than 0.8. (17.78%) The visual acuity of 11 children eyes (11/16, 68.75%) that had the secondary cataract after the operation was improved and 5 eyes (4/16,25%) were happened with recurrent secondary cataract after the anterior vitrectomy surgery. Within the 54 eyes of traumatic cataract with PCR treated by the anterior vitrectomy, 49 eyes (49/54,90.74%) were implanted the IOLs. 3 eyes (3/49,5.56%) had the BCVA below the 0.1, 6 eyes (6/49,11.12%) the BCVA 0.1—0.3, 17 eyes (17/49,31.48%) had the BCVA 0.3—0.5, 15 eyes (15/49,27.59%) had the BCVA 0.5—0.8, and 8 eyes had the BCVA more than 0.8. (8/49, 14.81%). All the 13 eyes of traumatic cataract with lens dislocation treated by anterior vitrectomy were implanted IOLs primarily. 2 eyes (2/13,15.38%) had the BCVA below the 0.1, 3 eyes (3/13, 23.08%) the BCVA 0.1—0.3, 7 eyes (7/13,53.84%) had the BCVA 0.3—0.8 and 1 eye1s had the BCVA more than 0.8 (1/13, 7.69%). Conclusions: Anterior vitrectomy has some useful in dealing with complicated anterior segmental operation.
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