目的:总结白内障超声乳化手术中发生的灌注液迷流综合征的临床表现和治疗方法。方法:从2002-09/2009-12我院共8例患者术中发生灌注液迷流综合征。这些患者的临床表现为突发性眼压升高、浅前房、虹膜脱出,通过注入黏弹剂以及升高灌注瓶高度无法维持前房深度。所有患者无明显疼痛、烦躁等症状。术中及术后间接眼底镜检查均未发现暴发性脉络膜出血等眼内出血现象。8例患者中1例未予特殊处理继续进行手术操作,其余7例患者经过缝合主切口,包眼安静休息联合200g/L甘露醇注射液快速静脉点滴处理。结果:未予特殊处理的1例患者手术中发生后囊膜破裂,进行前段玻璃体切除,悬吊人工晶状体。经过处理的7例患者中1例经过处理后前房仍无法形成,故行经睫状体平坦部玻璃体腔穿刺;其余患者前房形成,其中1例患者在植入人工晶状体后眼压再次升高,未予置换残余黏弹剂。所有患者手术完成后缝合主切口1针。结论:超声乳化术中灌注液迷流综合征是一种罕见的白内障术中并发症。经过恰当处理,可以解决突发高眼压引起的各种体征,顺利完成手术操作。

·AIM:To summarise the clinical manifestation and treatment of infusion misdirection syndrome during phacoemulisification.METHODS:There were 8 cases with infusion misdirection syndrome from September 2002 to December 2009.The clinical manifestations of these patients were suddenly heightened intraocular pressure,shallow anterior chamber,iris prolapse,and unsustainable anterior chamber depth through injection of viscoelastic material or heightened perfusion pressure.During that time,all patients had no significant pain,irritability or other symptoms.There was no intraocular hemorrhage by indirect ophthalmoscope examination during and after surgery.One of these 8 patients did not recieve any special handling,others were treated with the main incision suture,packet of eyes to rest and 200g/L mannitol injection rapidly.RESULTS:The one case,without special treatment,was performed anterior vitrectomy and intraocular lens suspension because of posterior capsular rupture during operation.After treatment of other 7 patients,1 patient was still unable to form anterior chamber,so pars plana vitreous cavity puncture was carried out;others formed anterior chamber,one of 7 cases had intraocular pressure heightened once again,so residual viscoelastic was not replaced.All the patients were sutured main incision after surgery.CONCLUSION:Infusion misdirection syndrome during phacoemulisification is one kind of rare complication.If it is treated properly,the physical signs originated by high intraocular pressure can be solved,and phacoemulsification can be finished successfully.

R779.66