小眼症患者施行白內障手術之經驗

Cataract Surgery in Patients with Nanophthalmos: Results and Complications

陳彥圭(Yen-Gui Chen) ； 賴盈州(Ing-Chou Lai) ； 陳勇仁(Yung-Jen Chen)

《中華民國眼科醫學會雜誌》 49卷1期 (2010/03) Pp. 113-117

https://doi.org/10.30048/ACTASOS.201003.0018

摘要

目的：報告小眼症患者施行白內障手術中的表現，手術方式與預後。
方法：二例三隻眼睛之小眼症患者接受超音波晶體乳化術摘除白內障。經病例回顧來觀察探討其臨床表現，手術方法，併發症及預後。
結果：白內障均順利摘除，手術中並無併發症發生。經平均兩年的觀察術後視力皆維持穩定，並無自發性脈絡膜滲出(Choroidal effusion)的發生。術後眼壓得以維持穩定，無須另以輔助藥物控制。
結論：小眼症為一罕見的疾病。由於其結構上的特異，包括鞏膜增厚及經鞏膜前房液排出阻力增加，導致手術中及手術後自發性脈絡膜滲出(Choroidal effusion)的發生率增高。經由本研究結果顯示小眼症病患在施行超音波晶體乳化術摘除白內障時，特殊的手術考量可以確保手術成功與避免併發症的發生。

並列摘要

Purpose: To evaluate the outcomes of phacoemulsification and intraocular lens (IOL) implantation combined with prophylactic anterior sclerotomy in nanophthalmic eyes.
Methods: Three nanophthalmic eyes of two patients had uneventful phacoemulsification and posterior chamber IOL implantation. The records of consecutive patients were reviewed for ocular diagnoses, keratometry, axial length, retinal-choroidal-scleral thickness, ocular surgeries, visual acuity, and complications. All operations were performed by the same surgeon.
Results: Spontaneous choroidal effusion did not occur intraoperatively and postoperatively during an average follow-up of two years. The final visual outcome remained stable. Glaucoma control was improved without treatment of topical medicine.
Conclusions: Nanophthalmos is a rare disease and shows tendency toward spontaneous or postoperative choroidal effusion, caused by abnormalities of the sclera and increased resistance to transscleral fluid outflow. Simultaneous anterior sclerotomy in cataract surgery with nanophthalmos is effective in avoiding the high risk of vision-threatening posterior segment complication.

並列關鍵字

Cataract surgery ； Choroidal effusion ； Nanophthalmos ； Sclerotomy