白内障手术过程及并发症XIAOPPT课件.ppt

Use this master to format text and chart slides,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,.,*,USE THIS MASTER FOR BOTTOM IMAGE TITLE,.,*,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,.,*,USE THIS MASTER FOR BOTTOM IMAGE TITLE,Use this master to format text and chart slides,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,USE THIS MASTER FOR BOTTOM IMAGE TITLE,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,USE THIS MASTER FOR BOTTOM IMAGE TITLE,超乳手术,用高频率的超声针头把发生白内障的晶状体碎裂成小的碎块,保留囊袋以植入,IOL,微,小切口（切口直径,1.8mm,）,超乳手术的发展,双手超乳手术（切口直径小到,1.4 mm,）,小切口,1,.,灌注和抽吸,融合在同一操作手柄,常常需要一个直径,1.0mm,的辅助切口,同轴超乳手术,灌注,抽吸,2,.,双手超乳手术,灌注和抽吸,分别在两个无套管的手柄,2,个微切口直径约,1.5 mm,灌注,抽吸,灌注,抽吸,3,.,现代白内障手术的步骤,切口,-,透明角膜或巩膜切口,5,.,注入黏弹剂,6,.,撕除晶状体前囊膜,7,.,晶状体核水分层,8,.,水分离：,将晶状体与晶状体囊膜分开,水分层：,将晶状体核与皮质分开，使晶状体或晶状体核能够旋转,平衡盐溶液,（,BSS,）,9,.,水分离,10,.,晶状体核超声乳化,11,.,将晶状体核乳化为小碎块,12,.,移除晶状体碎核块,13,.,移除晶状体外核层,14,.,轻柔地移除晶状体皮质,15,.,黏弹剂注入囊袋内,16,.,人工晶状体植入（硬型或可折叠型）,17,.,清除黏弹剂,18,.,人工晶状体的最终形状,19,.,白内障手术并发症,术中并发症,后囊膜破裂（严重并发症）,囊膜撕裂口边缘撕裂,器械或晶状体核动作过大,手术器械或超乳针头过度碰触后囊膜,后囊膜撕裂会导致,玻璃体脱入后房,/,前房,晶状体碎片进入眼底后极部,缺乏支撑,IOL,的囊膜,损伤虹膜,术者经验不足,患者瞳孔过小,20,.,术后早期并发症,切口渗漏,缺乏手术技巧,角膜水肿,由于角膜内皮细胞过度丢失,通常丢失了,5%,的角膜内皮细胞,多发生在术后的头几天,切口烧灼伤,一过性眼压升高,眼内感染（眼内炎）,很少发生但后果严重（,0.2%,）,白内障手术并发症,21,.,晚期并发症,影响光线通过引起的症状,眼内,/,眼外,/,边缘眩光,IOL,不能位于光轴的正中位置,后囊膜混浊（,PCO,）,发生在,20-25%,术后两年的患者,晶状体上皮细胞（,LEC,）从前囊膜的后部迁移并聚集在后囊膜导致“继发性混浊”或称,后囊膜混浊（,PCO,）,白内障手术并发症,22,.,晚期并发症,后囊膜混浊（,PCO,）,发生在,20-25%,术后两年的患者,晶状体上皮细胞（,LEC,）从前囊膜的后部迁移并聚集在后囊膜导致“继发性混浊”或称,后囊膜混浊（,PCO,）,白内障手术并发症,PCO,23,.,