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角膜破裂

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Postoperatively, B group (36 eyes) were dropped with TobraDex and artificial tears(Dextran 70 Eye Drops), and were given mydriasis and antiglaucoma eyedrops when necessary. Uncomfortable symptoms ( dry sensation, foreign body sensation,Burning sensation) were inquired, as well as tear break-up time, Schirmer test value and corneal fluorescein staining were measured 1 day preoperatively plus 3, 7, 14, 30 days postoperatively.

继续收集36例(36眼)患者全部纳入B组,手术后应用妥布霉素地塞米松眼液、眼膏和人工泪液Dextran 70 Eye Drops,必要时联合应用散瞳眼液和降眼压眼液。B组病例分别于术前1d,术后3d、7d、14d及30d详细询问患者是否存在不适症状(干涩感、异物感、烧灼感)并评分,并行泪膜破裂时间(Break-Up Time,BUT)、泪液分泌试验(Schirmer test,ST)、角膜荧光素染色(Cornea Fluorescein Staining,CFS)检查及评分。

Uncomfortable symptoms(dry sensation, foreign body sensation,Burning sensation) were inquired, as well as tear break-up time, Schirmer test value and corneal fluorescein staining were measured 1 day preoperatively plus 1, 3, 7, 14, 30 days postoperatively.

分别于术前1d,术后1d、3d、7d、14d及30d询问患者是否存在不适症状(干涩感、异物感、烧灼感)并评分,并行泪膜破裂时间(Break-Up Time,BUT)、泪液分泌试验(Schirmer test,ST)、角膜荧光素染色(Cornea Fluorescein Staining,CFS)检查及评分。

RESULTS: Complications including cornea injury, iris injury, posterior capsule rupture, iris prolapse and hyphema, were mainly caused by inexpert skill and lacking of experience.

术中并发症主要是角膜损伤、后囊膜破裂、虹膜损伤、虹膜脱出、前房出血,主要原因是技术不熟练和操作经验不足。

CASE REPORTSThe examination including slitlamp examination, tear breakup time, schirmer I test and fluorescent staining were performed in 97 outpatients with symptoms of asthenopia, foreign body sensation and dryness. The positive cases in BUT, SIt, fl staining and obstruction of tarsal glands and were 51,38,31 and 34 cases, respectively.

病例报告]对97例具有视疲劳、异物感及眼干涩等症状的门诊患者进行裂隙灯检查、泪膜破裂时间实验、泪液分泌实验及角膜荧光染色等检查,所有患者中泪膜破裂时间实验、泪液分泌实验、角膜荧光染色及睑板腺异常的阳性例数分别为51,38,31,34例。

The major complications were corneal edema and posterior capsular rupture.

手术主要并发症有角膜水肿和后囊破裂。

RESULTS: Among 200 cases operations, 7 cases posterior capsular rupture, 2 cases rupture of the iridodialysis, 52 cases corneal endothelial edema after 1 day, 11 cases hyphema., 3 cases IOL dislocation, 2 cases incision leakage.

结果:200例术眼中,后囊膜破裂7例,虹膜根部离断2例,术后1d角膜内皮水肿52例,前房积血11例,人工晶状体偏位3例,切口渗漏2例,术后1mo,视力均>0.2,术后6~18mo视力≥0.5的181例,占90.5%,平均散光(0.97±0.52)D。

Operative effect and complications of intraoperative and postoperative were observed.RESULTS: Among 200 cases operations, 7 cases posterior capsular rupture, 2 cases rupture of the iridodialysis, 52 cases corneal endothelial edema after 1 day, 11 cases hyphema., 3 cases IOL dislocation, 2 cases incision leakage.

结果:200例术眼中,后囊膜破裂7例,虹膜根部离断2例,术后1d角膜内皮水肿52例,前房积血11例,人工晶状体偏位3例,切口渗漏2例,术后1mo,视力均>0.2,术后6~18mo视力≥0.5的181例,占90.5%,平均散光(0.97±0.52)D。

Results Totally 550 eyes' the best corrected visual acuity was more than 0.51-3 months after surgery, accounting for 94.83%; 30 eyes (5.17%) had iris prolapse and intraoperative complications; 4 eyes (0.69%) had iridodialysis; 6 eyes 1.03% had posterior capsule rupture; 30 eyes (5.17%) had hyphema; 30 eyes had (5.17%); 109 eyes (18.79%) had postoperative complications, including corneal edema in 50 eyes (8.62%, of which endothelial-like opacity in 40 eyes); 40 eyes (6.90%) had inflammation of anterior chamber; 10 eyes (1.72%) had transient high intraocular hypertension; 5 eyes (0.86%) had hyphema, 4 eyes had pupillary capture.

结果 术后1~3月最佳矫正视力大于等于0.5的有550只眼(94.83%),术中并发症,虹膜脱出30只眼(5.17%),虹膜根部离断4只眼(0.69%),晶状体后囊破裂6只眼(1.03%),前房出血30只眼(5.17%),后弹力层脱离30只眼(5.17%)。术后并发症109只眼(18.79%)包括角膜水肿50只眼(8.62%,其中内皮条样混浊40只眼),前房纤维渗出40只眼(6.90%),短暂性高眼压10只眼(1.72%),前房积血5只眼(0.86%)瞳孔夹持4只眼(0.70%)。

Serious violent cornea can rupture, iris, or ocular contents prolapse, anterior chamber shallowing or disappearance of the pupil was pear-shaped .

严重的暴力可使角膜破裂,虹膜或眼内容物脱出,前房变浅或消失,瞳孔呈梨形。

RESULTS: In Phaco group, 79.2% of the patients visual acuities at the first day after operation were≥0.3. In this group, the nuclear hardnesses of some patients catract were ≤Ⅲ, and others ≥Ⅳ; complications occurred in the former including capsule rupture and vitreous prolapse(4.3%), corneal edema (22.2%); while the latter were 13.7% and 68.6%, respectively.

结果:Phaco组视力≥0.3者79.2%,核硬度≤Ⅲ者后囊膜破裂玻璃体脱出发生率4.3%,角膜水肿发生率22.2%,核硬度≥Ⅳ者后囊膜破裂玻璃体脱出13.7%,角膜水肿68.6%;MSICS组视力≥0.3者78.1%,核硬度≤Ⅲ者后囊膜破裂玻璃体脱出发生率3.8%,角膜水肿发生率19.0%,核硬度≥Ⅳ度者后囊膜破裂玻璃体脱出发生率5.7%,角膜水肿发生率14.3%。

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