劈核乳化白内障吸除术中后囊膜破裂的临床分析  

Clinic analysis of postcapsular rupture in chop-phacoemulsification

作　　者：王祥群[1] 曾骏文[1] 

机构地区：[1]中山大学中山眼科中心,广州510060

出　　处：《中国实用眼科杂志》2005年第11期1212-1214,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的对劈核乳化白内障手术全过程进行阶段分解,旨在明确不同手术阶段后囊膜破裂的发生原因及分布规律,强化对破裂高发阶段的后囊膜保护,减少破裂发生。方法劈核乳化手术过程划分为五个阶段:环形撕囊与水分离阶段、劈核阶段(1→2/2→4/4→8/8)、碎核乳化早期阶段(8/8→6/8→4/8)、碎核块乳化后期阶段(4/8→2/8→0/8)、碎皮质吸除阶段;依此划分对46例后囊膜破裂病例的发生原因及发生率进行阶段间的对比分析。结果晶状体囊膜张力、机械、负压及超生能量是劈核乳化手术中四个常见的后囊膜致伤因素,其中负压因素较为多见;碎核块乳化后期(4/8→2/8→0/8)是后囊膜破裂最为高发的阶段(40.3%),明显高于其他手术阶段(χ2=11.27,P<0.02),呈现相对集中的分布特征。结论后囊膜破裂的发生原因及发生率存在着阶段分布差异;在破裂高发的碎核块乳化后期,需要强化对负压的精确控制以维持手术空间液流容量及后囊膜位置的稳定,减少损伤的发生。Objective To determine the difference of causes and postcapsular rupture raters （PCRR） in stages of chop- phacoemulsification and pay more attention to protect postcapsular from injuries in dangerous operation stage. Methods The operation process of chop phacoemulsification was divided into five stages： continuous curvilinear capsularhexis （CCC） and hydrodissection stage, chop stage （1→2/2→4/4→ 8/8）, early stage of crushed nuclear removing （8/8→6/8→4/8）, later stage of crushed nuclear removing （4/8→2/8→0/8） and stage of residual cortex removing. Difference of causes and PCRR were compared among these stages in 46 case,s （46eyes）. Results Compared to capsular tension, mechanical injuries and phaco energy, vaccum is the commonest cause to injure postcapsular. PCRR in later stage of crushed nuclear removing （40.3 % ） was higher than any other stage （X^=11,27, P 〈 0.02 ）. Conclusions Difference of causes and PCRR exist among stages of chop phacoemulsification. More attention and protection measures should be paid to prevent postcapsular from injuries in later stage of crushed nuclear removing.

关 键 词：超声乳化白内障吸出术 后囊膜 

分 类 号：R779.66[医药卫生—眼科] R776.105[医药卫生—临床医学]