注水法挽核在白内障现代囊外摘除术中的应用  

The application of the water-injection method for the nucleus delivery in extracapsular cataract extraction

作　　者：张学东[1] 刘朝辉[1] 李琦[1] 李平华[1] 

机构地区：[1]重庆医科大学附属第一医院眼科,400016

出　　处：《重庆医学》2005年第4期540-540,542,共2页Chongqing medicine

摘　　要：目的介绍注水法挽核在巩膜隧道白内障现代囊外摘除手术中的应用.方法在745只眼(年龄40岁以上)施行巩膜隧道切口白内障现代囊外摘除手术,环形撕囊或开灌式截囊,扩大切口6mm,水分离、水分层晶体核,使核变小变薄,并将其脱位.用注水针头向前房内注水并轻压切口后唇,将核挽出.结果所有病人用注水法挽出晶体全部成功.视力:术后1d裸眼视力或矫正视力≥0.5者,注水法组为72%,对照组为45%,术后第一周裸眼视力或矫正视力≥0.8～1.0,注水法组为40%,对照组为24%,术后3个月,裸眼或矫正视力达0.8～1.0者,注水法组为80%,对照组为54%.两组病人视力有显著性差异P＜0.05.结论注水法挽出晶体核是一种简单易行的手术方式,具有切口小,散光少,晶状体悬韧带断离、后囊膜破裂及玻璃体脱出发生率低、术后视力恢复好的优点.Objective To study the application of the water-injection method (WIM) for nucleus delivery in the operation of extracapsular cataract extraction (ECCE) through scleral tunnel incision (STI).Methods STI and ECCE were performed on 745 eyes (> 40 years old). Circular capsulorhexis were made, the incision was enlarged about 6-7 mm, hydrodissection, hydrodelineation nucleuses were made for making nucleus smaller and thinner. And finally nucleus was removed from original site. Using needle to inject water into anterior chamber and then press the post lip of the incision softly, making the nucleus delivered.Results Nucleus delivery was made successfully in all patients with using WIM. Vision one day after the operation, the percentage of the vision of the naked eye or adjusted vision ≥0.5, the WIM group was 72%, the controlled group was 45%. One week after the operation, the vision of the naked eye or the adjusted vision ≥ 0.8-1.0, the WIM group was 40%, the controlled group was 24%. Three months after the operation, the vision of the naked eye or the adjusted vision reaches 0.8-1.0, the WIM group was 80%, and the controlled group was 54%. The vision between two groups had significant differences statistically (P<0.05 ) .Conclusion Nucleus delivery using WIM is a simple and easy operation fashion.This operation fashion has advantages of smaller incision, less astigmatism, lower incidences of crystalline zonule severed, posterior capsular rupture and vitreous crystalline lens extrication, and vision recovered well after operation.

关 键 词：注水法 挽核 白内障 人工晶体 

分 类 号：R779.66[医药卫生—眼科]