小切口手法碎核白内障摘除术临床应用
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摘要
目的探讨小切口手法碎核白内障囊外摘除联合人工晶状体植入术的临床疗效,手术技巧及并发症。方法表面麻醉或加球筋膜下麻醉,对163例(184眼)白内障采用反眉形巩膜隧道切口,连续环形撕囊或开罐式截囊,充分水分离,单手或双手法旋核,手法碎核,分二块取出晶状体核,植入后房型人工晶状体。结果术中后囊破裂6眼(3.26%),晶体悬韧带断裂2眼(1.09%),虹膜根部断离1眼(0.54%),角膜内皮轻度水肿18眼(9.78%)。术后第1天矫正视力0.5以上者140眼(76.09%),术后1周矫正视力0.5以上者159眼(86.41%),术后1月矫正视力0.5以上者165眼(89.67%)。178眼(96.74%)。无严重的术中及术后并发症。结论手法碎核白内障摘除术具有切口小,愈合快,并发症少,设备简单,临床效果满意,值得推广和应用。
Objetive To investigate the clinical effects, surgical techniques and complications of manual nucleofragmentation extracapsular cataract extraction and intraocular lens implantation. Methods After topical or/and sub Tenon's anaesthesia, 163 cases (184 eyes) received anti-eyebrow-shaped scleral tunnel incision, continuous curvilinear capsulorhexis or can opener capsulectomy, hydrodissection, single or dual manualnuclear rotation, manual nucleofragmentation, removing two blocks of lens nucleus, and posterior Chamber intraocular lens implantation. Results 6 eyes(3.26%) suffered from posterior capsular rupture during operation, 2 eyes (1.09%) suffered from zonular dialysis, 1 eye (0.54%) suffered from iris root breaking away, 18(9.78%) eyes suffered from mild corneal endothelial edema. The number of eyes whose best corrected VA on postoperative 1 day 0.5 or better was 140 (76.09%). After 1 week, the number achieved 159 (86.41%), and after 1 month, the number was 165 (89.67%). There were no serious complications in all cases. Conclusions The manual nucleofragmentation extracapsular cataract extraction with small incision, faster healing, fewer complications, simple equipment, satisfactory clinical effect, is worthy of promotion and application.
Objetive To investigate the clinical effects, surgical techniques and complications of manual nucleofragmentation extracapsular cataract extraction and intraocular lens implantation. Methods After topical or/and sub Tenon's anaesthesia, 163 cases (184 eyes) received anti-eyebrow-shaped scleral tunnel incision, continuous curvilinear capsulorhexis or can opener capsulectomy, hydrodissection, single or dual manualnuclear rotation, manual nucleofragmentation, removing two blocks of lens nucleus, and posterior Chamber intraocular lens implantation. Results 6 eyes(3.26%) suffered from posterior capsular rupture during operation, 2 eyes (1.09%) suffered from zonular dialysis, 1 eye (0.54%) suffered from iris root breaking away, 18(9.78%) eyes suffered from mild corneal endothelial edema. The number of eyes whose best corrected VA on postoperative 1 day 0.5 or better was 140 (76.09%). After 1 week, the number achieved 159 (86.41%), and after 1 month, the number was 165 (89.67%). There were no serious complications in all cases. Conclusions The manual nucleofragmentation extracapsular cataract extraction with small incision, faster healing, fewer complications, simple equipment, satisfactory clinical effect, is worthy of promotion and application.
引文
[1]李一壮.刘爱平.陈晖.圈垫式劈核技术在白内障摘除术中的应用.中华眼科杂志,2002,38:728-730.
[2]颜伟年.王建华.钱晓娃,等.老年性白内障晶体测量结果及其对临床的意义.中国实用眼科杂志,1995,13:149-150.
[3]薛龙全.肖伟.超声乳化术中转换为非超声乳化小切口白内障手术的临床研究.中国实用眼科杂志,2002,20:617.
[4]李钟实,冯瑞芳,赵凤蕾,等.斜向切核及捆绑式娩核在白内障摘除术中的应用.中华眼科杂志,2006,42:620.
[5]朱海容.隧道式小切口白内障囊外摘出术的碎核技术.眼外伤职业眼病杂志,2004,26:696.
[6]王山巍,安道杰,王山岿,等.白内障小切口线切割碎核人工晶状体植入术的临床探讨.眼外伤职业眼病杂志,2006,28:782-783.
[7]张瑞君.李栋.张柏新.倍诺喜表面麻醉下小切口非超声乳化白内障术.中国实用眼科杂志,2003,21:加页5.
[8]林振德.李绍珍.小切口白内障手术.北京:人民卫生出版社,2002:30.
[2]颜伟年.王建华.钱晓娃,等.老年性白内障晶体测量结果及其对临床的意义.中国实用眼科杂志,1995,13:149-150.
[3]薛龙全.肖伟.超声乳化术中转换为非超声乳化小切口白内障手术的临床研究.中国实用眼科杂志,2002,20:617.
[4]李钟实,冯瑞芳,赵凤蕾,等.斜向切核及捆绑式娩核在白内障摘除术中的应用.中华眼科杂志,2006,42:620.
[5]朱海容.隧道式小切口白内障囊外摘出术的碎核技术.眼外伤职业眼病杂志,2004,26:696.
[6]王山巍,安道杰,王山岿,等.白内障小切口线切割碎核人工晶状体植入术的临床探讨.眼外伤职业眼病杂志,2006,28:782-783.
[7]张瑞君.李栋.张柏新.倍诺喜表面麻醉下小切口非超声乳化白内障术.中国实用眼科杂志,2003,21:加页5.
[8]林振德.李绍珍.小切口白内障手术.北京:人民卫生出版社,2002:30.