| Objective:To study the applicability of modified transparent corneal incision and posterior capsulotomy with silicone oil extraction combined with cataract phacoemulsification and intraocular lens(IOL)implantation.Methods:Retrospective study.1.Patient collection: From January 2016 to June 2017,collect inpatients who met the criteria for inclusion in this study in our hospital.2.Surgical methods:(1)Transscleral puncture and perfusion catheter;(2)Phacoemulsification cataract extraction;(3)Posterior capsular incision;(4)Silicone oil extraction;(5)Intraocular lens implantation.3.Postoperative follow-up time: Follow-up observation at 1d,1w,4w,12 w and24w after operation.4.Observation indicators: Postoperative best-corrected visual acuity(BCVA),intraocular pressure(IOP),corneal edema,anterior inflammatory reaction,IOL position,posterior capsulotomy size,residual silicone oil,retinal detachment,and other complications.Result:1.From January 2016 to June 2017,45 eyes were collected in 45 eyes,5 eyes were removed in 5 eyes,and 40 eyes in 40 eyes completed clinical observations.Among them,there were 16 cases of liver and kidney deficiency,5 cases of hepatocirrhosis,5 cases of qi deficiency and blood stasis,8 cases of qi stagnation and blood stasis,and 6 cases of damp heat or convulsive fever.2.BCVA: Compared with preoperative,1 day after surgery,12 eyes improved,24 eyes decreased,25 eyes increased at 1 week after surgery,7 eyes decreased,35 eyes improved at 4w,12 w,24w after surgery,and 3 eyes decreased.3.IOP:At 1d after operation,high IOP was 1 eye,and normal IOP were 34 eyes,and low IOP 5 eyes;at postoperative 1w high IOP were 2 eyes,and normal IOP32 eyes,low IOP 6 eyes;at postoperative 4w high IOP in 3 eyes,and normal OP in 33 eyes,low IOP in 4 eyes;at postoperative 12 w high IOP in 1 eye,normal IOP in 35 eyes,low IOP in 4 eyes;at postoperative 24 w high IOP in 5eyes,normal IOP in 29 eyes,low IOP 6 eyes.4.Corneal edema: Corneal edema was performed on postoperative 1d for 23 eyes in grade 0,grade 13 in grade 1,grade 3 in grade 3,grade 1 in grade 3;postoperative 1w had grade 0 in 34 eyes,grade 1 in 3 eyes,grade 2 in 1 eye,and grade 3 in 0 eyes;postoperative 4w 0 grade 39 eyes,grade 1 eye,grade 2 and grade 3 0 eyes;postoperative 12 w and 24 w grade 0 40 eyes,grade 1,grade 2 and grade 3 were 0 eyes.5.Anterior inflammatory reaction: Atrial turbidity was observed in 35 eyes of grade0,grade 5 eyes,grade 2 and grade 3 eyes on the 1st postoperative day;atrial turbidity grade 40 eyes,grade 1,grade 2 and grade 3 eyes were observed at the remaining observation time points.6.IOL position: At 4w postoperatively,the intraocular lens was moved down,and the rest of the observation time was normal.7.Posterior capsulotomy size: At 24 weeks postoperatively,the central circular incision of the posterior capsule incision was enlarged and deviated upwards or to the side of the nose,showing an ellipse;no abnormality was observed in the rest of the observation time.8.Fundus situation: The incidence of silicone oil residue in 3 eyes was 7.5% at 1d,1w,4w,12 w and 24 w after operation,and retinal detachment occurred in 3 eyes after operation.The incidence was 7.5%.One eye had retinal detachment after 1week and two at 4w after operation.There was no retinal detachment during the rest of the observation time;other complications such as choroidal detachment,vitreous hemorrhage,and endophthalmitis were not observed during follow-up.9.There were no complications such as hyphema,scleral collapse,retinal detachment,choroidal detachment,and fulminant choroidal detachment during surgery.Conclusion:The modified transparent corneal incision and posterior capsulotomy of silicone oil extraction combined with cataract phacoemulsification and IOL implantation have good visibility,can effectively reduce the number of operations,and reduce the incidence of silicone oil residues and retinal complications after silicone oil emoval.So this Surgical approach has certain applicability,and can be promoted in clinical practice. |
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