【摘要】  　　目的：评价高龄白内障患者超声乳化人工晶状体植入术的临床疗效及安全性。方法：对184例（221眼）80～103岁老人行白内障超声乳化人工晶状体植入术，对术后视力、并发症对比分析。结果：术后1wk脱盲率95.0%，脱残率77.8%。无严重局部及全身并发症发生。49眼术后1wk视力≤0.3，其中眼底病变占41眼(83.7%)。结论：高龄白内障患者行超声乳化人工晶状体植入术安全、有效。眼底病变是影响术后视力恢复的主要原因。

【关键词】  白内障　高龄　超声乳化　人工晶状体

　　Analysis of the effect of phacoemulsification and IOL implantation for aged patients

    Xiang Ma

    Department of Ophthalmology, People's Hospital of Liuzhou City, Liuzhou 545001, Guangxi Province,China

    Abstract AIM: To evaluate the clinical effect and safety of the phaco + IOL of the cataract in the advanced age. METHODS: One hundred and eighty-four cases (221 eyes, 80-103 years) were made the phaco + IOL. The acuity of vision and complication were analyzed. RESULTS: The out of blindness rate and out of disability were 95.0% and 77.8%, respectively in one week. None of the cases had the severe complication all over the body. Forty-one eyes had the fundus oculi affection in the 49 cases that the post-operation acuity of vision was below 0.3 (83.7%). CONCLUSION: The phaco + IOL of the cataract in the advanced age are safe and effective. The fundus oculi affection is the main reason that effect the recovery of the vision after the phaco + IOL of the advanced age.

    · KEYWORDS:cataract ; advanced age ; phacomulsification; IOL

　　 0引言

    为提高晚年生活质量而选择一种适宜于高龄白内障患者的手术方式，成为眼科医生关注的要点。我院1997-12/2006-03对184例221眼80岁以上白内障患者行超声乳化人工晶状体植入术，效果良好，报告如下。

    1对象和方法

    1.1对象 白内障患者184例221眼，年龄80～103岁。男104例125眼，女80例96眼。术前视力光感～0.3。晶状体核硬度按LOCSⅡ分级法，Ⅱ级核21眼，Ⅲ级核91眼，Ⅳ级核以上109眼。并存全身疾病148例（80.4%），主要的全身疾病有冠心病、高血压、糖尿病、脑血管病、慢性支气管炎、肾功能衰竭等。

    1.2方法 消毒毕眼后4g/L倍诺喜液滴眼3次行表面麻醉。颞上方透明角膜内1mm做隧道切口，对侧透明角膜缘内做辅助切口，前房注入高粘附性粘弹剂，用自制破囊针头做连续环行撕囊，充分水化分离，根据硬核类型不同采用不同碎核乳化技术，包括改良的分割碎核、保留皮质或裸核旋转刻蚀等方法将晶状体核粉碎吸除，抽吸晶状体皮质。再次向前房及囊袋内注入粘弹剂，将人工晶状体植入囊袋内或睫状沟。术终下穹窿部球结膜下注射地塞米松2.5mg＋庆大霉素2万U。

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