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目的 :观察眼外伤、青光眼、糖尿病及葡萄膜炎所致的瞳孔形态异常并伴有白内障的病人 ,行白内障现代囊外摘除术 (ECCE)中对瞳孔进行处理后 ,植入前房型人工晶状体 (AC IOL)或后房型人工晶状体 (PC IOL) 4 0例 4 2只眼术后疗效。方法 :对晶状体后囊膜完整的大瞳孔者 ,缝合虹膜、修复瞳孔 ,植入PC IOL。对晶状体后囊膜缺如或大破口的大瞳孔者 ,缝合虹膜、修复瞳孔 ,行前玻璃体切割术后 ,植入AC IOL。对虹膜广泛粘连、机化的小瞳孔 ,术中撕囊、挽核困难病例 ,分离粘连后瞳孔仍然不能散大 ,则行瞳孔缘放射状剪开 ,植入IOL。结果 :4 0例 4 2只眼视力康复满意。术后瞳孔保持在 3～ 5mm、圆形或近圆形 ,无严重并发症发生。结论 :对于各种原因所致瞳孔非正常状态的白内障 ,行ECCE +IOL手术时 ,只要仔细、适当的处理好瞳孔 ,IOL的植入已非禁忌 ,术后积极的抗炎、抗感染等药物的合理应用 ,已使这些病人的视力康复成为可能
OBJECTIVE: To observe the pupil morphology in cataract patients with cataract due to ocular trauma, glaucoma, diabetes mellitus and uveitis. The pupils were treated with ECCE in cataract and implanted into the anterior chamber intraocular lens AC IOL) or posterior chamber intraocular lens (PC IOL) 40 cases 42 eyes postoperative efficacy. Methods: For the large pupil of the posterior capsule of the lens, suture the iris, repair the pupil and implant the PC IOL. For large posterior capsular lens missing large or large pupil, suture the iris, repair the pupil, anterior vitrectomy, implantation of AC IOL. Extensive adhesion of the iris, the machine of small pupils, intraoperative capsulorhexis, difficult to pull the nucleus, the separation of adhesions after the pupil still can not be scattered, the line pupillary margin radially cut open, IOL implantation. Results: 40 cases of 42 eyes with satisfactory vision rehabilitation. After the pupil was maintained at 3 ~ 5mm, round or nearly circular, no serious complications. Conclusions: For cataract patients with abnormal pupil due to various reasons, IOL implantation is not contraindicated after ECCE + IOL surgery, so long as the pupil is properly and properly treated, active anti-inflammatory and anti-infection drugs The rational application of these patients has made it possible to achieve vision rehabilitation