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Cause and management of dislocated nuclear fragments during phacoemulsification

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收录情况: ◇ 北大核心 ◇ 中华系列

机构: [1]Department of Ophthalmology, Affiliated Tongren Hospital, The Capital Medical University, Beijing 100730, China.
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To investigate the cause and management of posteriorly dislocated lens nucleus in the vitreous cavity during phacoemulsification.The authors performed a retrospective study of 18 patients with dislocation of nuclear fragment into vitreous cavity during phacoemulsification at Tong Ren Hospital from August 1994 to January 1999.4 cases with dislocated nuclei floated in the anterior vitreous were removed by a lens loop from limbal extensive incision. 2 cases with their dislocated nuclei less than 1/4 of the normal size were under follow-up for 3 - 4 years, and no complications were observed. The final outcome in 1 case with a dislocated nucleus half of its normal size was ocular atrophy as a result of phacoanaphylactic endophthalmitis. 11 cases underwent pars plana vitrectomy. In the operation the nuclei were floated anteriorly by injection of perfluoro-1, 3-dimethylcyclohexane, then they were removed by a lens loop through the limbus and in 2 cases they were fragmented by ultrasound. The main post-operative complication was corneal edema. The final visual acuities generally were improved in varying degrees in 1 month to 4 years of follow-up.During phacoemulsification, the dislocation of a nucleus is liable to first occur in the peripheral sculpting stage, and secondly in central sculpting stage. A radial tear extending posteriorly from a discontinuous anterior capsulorrhexis is the major risk factor predisposing to posterior dislocation of the nucleus or nuclear fragment. During phacoemulsification, vitrectomy should be performed as soon as possible for a nucleus dislocated into middle or posterior vitreous cavity, and it is a safe and effective method for management of dislocated nucleus.

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第一作者机构: [1]Department of Ophthalmology, Affiliated Tongren Hospital, The Capital Medical University, Beijing 100730, China.
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