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目的 :分析后发障光切术后并发症及视力不增的原因及研究预防措施。方法 :对白内障现代囊外摘除及人工晶体植入术后 8d～ 5年后发障的 115例、148眼行Nd :YAG激光后囊膜光切术 ,术后次日复诊 ,随诊 7d～ 3个月。结果 :接受该法治疗的 115例 ,除 1例玻切术后硅油充满前房的患者膜切开不成功外 ,余者均切膜成功 ,成功率为 99.32 %。视力提高 10 8眼 ( 72 .97% ) ,不变 4 0眼 ( 2 7.0 3% )。视力由治疗前的 0 .31±0 .2 6提高到治疗后的 0 .56± 0 .37。结论 :后发障光切术是白内障术后因后发障而再次致盲患者有效的、非介入性的手术治疗 ,安全 ,患者无痛苦 ,成功率高 ,视力提高显著。白内障术后视力不提高系治疗前原有眼部病变所致 ,与激光治疗本身无相关性 ,并发症的发生则与激光能量及膜质量成正相关。因此 ,早期治疗和分次治疗可减少和预防并发症的发生。对Ⅲ级膜后发障的分次治疗尤为重要 ,可避免一次性过高使用能量 ,给周围组织带来不必要的损伤。
OBJECTIVE: To analyze the causes and preventive measures of postoperative complications of post-ophthalmotomy and visual acuity increase. Methods: 115 cases (148 eyes) with posterior capsulotomy after modern extracapsular cataract extraction and intraocular lens implantation were treated by Nd: YAG laser posterior capsular photocoagulation. The follow - up day after operation was followed up for 7 days - 3 months. Results: In 115 cases treated with this method, except for one case whose membrane was filled with silicon oil filled anterior chamber in patients with silicone oil failed to be incised successfully, the others were succeeded in transrectal membrane. The successful rate was 99.32%. Visual acuity increased by 108 eyes (72.97%), unchanged 40 (2 7.03%). Visual acuity increased from 0.31 ± 0.26 before treatment to 0.56 ± 0.37 after treatment. CONCLUSION: Post-cataract surgery is a effective and non-invasive surgical treatment for patients with secondary blindness after cataract surgery. It is safe and patient-free with high success rate and significant improvement of visual acuity. The improvement of visual acuity after cataract surgery was caused by the original ophthalmic lesions before treatment, which had no correlation with laser treatment itself. The incidence of complications was positively correlated with laser energy and membrane quality. Therefore, early treatment and fractionated treatment can reduce and prevent the occurrence of complications. The grade Ⅲ membrane posterior barrier failure treatment is particularly important, to avoid excessive use of energy once, to bring unnecessary damage to the surrounding tissue.