表麻下小切口非超声乳化白内障摘除联合IOL植入术的临床研究.doc

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1、表麻下小切口非超声乳化白内障摘除联合10L植入术的临床研究作者：李明华，朱增钦，赵俊华，梁建超【摘要】目的：探讨表面麻醉下小切口非超声乳化白内障摘除联合人工晶状体植入术的临床效果和安全性。方法：对200701/200801在我院住院治疗的白内障患者105例113眼实施表面麻醉下小切口非超声乳化白内障摘除联合人工晶状体植入术，观察临床效果。结果：术中麻醉效果明显，显效共107眼(94.7%),有效6眼(5.3%)，总有效率达100%,无病例因疼痛无法承受手术而改行球后或球周麻醉。术后第Id裸眼视力>0.5者65眼(57.5%),>0.8者22眼(19.5%);术后

2、lwk裸眼视力>0.5者85眼(75.2%),>0.8者17眼(15.0%),随访Imo未发现明显视力下降。术后lwk视力<0.5者1例(0.9%),为糖尿病视网膜病变。术后角膜内皮水肿7眼(6.2%),高眼压4眼(3.5%),经处理后症状均消失。结论：表面麻醉下小切口非超声乳化白内障摘除联合人工晶状体植入术的临床效果确切，安全性高，值得推荐应用。【关键词】表面麻醉；小切口；非超声乳化；白内障摘除；人工晶状体植入术AbstractAIM:Toinvestigatetheeffectandsaftyofsmal1incisionnonphacoemulsif

3、icationcataractextractioncombinedwithintraocularlens(IOL)implantationundertopicalanesthesia・METHODS:ThecaseswithcataractinourhospitalfromJanuary2007toJanuary2008receivedsmallincisionnonphacoemu1sificationcataractextractioncombinedwithIOLimplantationundertopicalanesthesia,andtheclinicale

4、ffectwasobserved.RESULTS:Theeffectofanesthesiawasobviousinoperation，theexcellenceratewas94.7%andgoodratewas5.3%andthetotaleffectiveratewas100.0%.Therewasnocasewhoreceivedanesthesiaofbehindtheeyeballandaroundtheeyebal1becauseofpain.Therewere65eyes(57.5%)withnakedvision0.5oraboveand22eyes

5、(19.5%)withnakedvisionmorethan0.8inonedayafteroperation.Therewere85eyes(75.2%)withnakedvision0.5oraboveand17eyes(15・0%)withnakedvisionmorethan0.8inonedayafteroperation.Al1ofthemwerefollowedupforonemonthandnocasewaswithdecressedvision.Therewasonecase(0.9%)withnakedvisionlessthan0.5becaus

6、eofdiabeticretinopathy.Therewere7eyes(6.2%)withcornealendotheliumedema,4eyes(3.5%)withbulbihypertonia,andal1ofsymptomdisappearedafterdea1ing.CONCLUSION:TheeffectofsmallincisionnonphacoemulsificationcataractextractioncombinedwithIOLimplantationundertopicalanesthesiaisobviousandsafe,soiti

7、sworthbeingusedwidely.KEYWORDS:topicalanesthesia;smallincision;nonphacoemulsification;cataractextraction;intraocularlensimplantationo引言白内障是眼科发病率极高的眼病之一，严重影响患者的生活质量。而球后麻醉或/和球周麻醉是传统白内障手术的主要麻醉方式，但因其并发症较多，限制了其在临床的进一步应用。我们对200701/200801在我院住院治疗的白内障患者采用表面麻醉下小切口非超声乳化白内障摘除联合人工晶状体植入术进行治疗