微切口冷超声乳化白内障摘除折叠式人工晶体植入术探讨  

Ultrasmall-incision bimanual phacoemulsification and foldable intraocular lens implantation through a 2mm incision

作　　者：李建平[1] 夏文清[1] 郑敏[1] 满晓飞[1] 刘焕明[1] 

机构地区：[1]山东大学临床医学院,济南市中心医院眼科,济南250013

出　　处：《中国实用眼科杂志》2006年第11期1152-1154,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨2mm微切口冷超声乳化白内障摘除术技术及可行性,评价其临床疗效。方法我们对86例(117只[)老年性白内障施行了双切口冷超声乳化白内障摘除并2mm微切口折叠人工晶体植入术。对灌注劈核器进行了相应改造,对超声乳化仪技术参数进行了筛选调整。于3点和11点方位角巩膜缘分别行1.2mm×1.2mm、1.5mm×1.2mm切口,灌注劈核器、超声乳化无套管探头分别通过双切口进入前房,超声能量采用间歇释放/强度线性调整模式,采用快速劈裂法乳化核组织,扩大切口至2mm植入折叠式人工晶体。观察手术中超声能量应用情况、乳化时间、术中术后并发症,追踪观察术后视力及散光情况。结果超声能量和乳化时间:核硬度为II级者平均应用能量(3%)/平均乳化时间为(0.57±0.37)min;III级核平均应用能量(8%)/平均乳化时间为(068±0.58)min;IV级核平均应用能量(11%)/平均乳化时间为(1.35±0.95)min。术后首日裸[视力≥0.5者占94.3%,≥1.0者占40.5%;术后一周,平均散光(0.76±0.59)D,与术前散光比较无显著性差异(p>0.05)。117只[中,9只[(7.7%)术后切口周围浸润水肿,1-2天后恢复透明,无角膜切口灼伤、严重水肿、后囊破裂、切口漏液、前房异常等并发症。结论微切口冷超声乳化白内障摘除手术具有良好的临床疗效,为更新人工晶体的研发奠定了基础。具有临床的可操作性和开拓价值。Objective To explore the possibility and technology of ultrasmall-incision bimanual phacoemulsification through a 2mm incision, and evaluate its clinical effect. Methods We performed bimanual cold phacoemulsification and intraocular lenses implantation through a 2mm incision with 86 cases （117 eyes） of senile cataract since March, 2004. We modified the aspiration chopper, and adjusted phacoemulsification settings.Surgery technology： We performed two small incision in limbus of corneoscleral at 3 and 11 oclock seperatly, one is 1.2mm × 1.2mm. Asperation chaopper and sleeveless phaco tip were inserted into anterior chamber through two small incions. We adapted intermittent release/power lineal adjustment mode of ultrasound power, used quick-chop method, and implanted foldable intraocular lens through an enlarged 2mm incision. Ultrasound power, phaco time, complications of operation and post-operation, visual utcome and astigmatism were oberseved. Results Ultrasound power and phaco time： nucleus hardness Ⅱ： the average ultrasound power （3%）/average phaco time is （0.57 ± 0.37）min, nucleus hardness Ⅲ： the average ultrasound power （8%）/ average phaco time is （0.68 ± 0.58）min. Uncorrectedvision acuity of 1^st day post-operation ≥ 0.5 accounts for 94.3%, ≥ 1.0 accounts for 40.5%, the average of astigmatism of 1^st week post-operation is （0.76 ± 0.59）D, without significant difference compared with preopertaion （p〉0.05）. 9eyes （7.7%） in 117 eyes had corneal edema postoperatively, but recovered after 1-2 days. There were no complications, such as corneal burn, serious edema, posterior capsular rupture, wound leskage, and anterior chamber abnormal. Conclusionl Ultrasmall- incision bimanual phacoemulsification is a very effective and efficient cataract surgery which is feasible and evaluable in the clinic, and is the basis of the research and creation of newer type of intraocular.

关 键 词：白内障 冷超声 乳化 

分 类 号：R779.66[医药卫生—眼科]