连续环行撕囊及手法碎核在无缝线小切口非超声乳化白内障术中的应用  

Application of continuous curvilinear capsulotomy and manual neucleus division in small incision with no suture non-phaco extra-capsula cataract extraction procedure

作　　者：王小荣 周爱丽 傅优凤[2] 

机构地区：[1]浙江桐庐县第一人民医院眼科 [2]中国医科大学绍兴华宇医院

出　　处：《中国中医眼科杂志》2007年第1期17-19,共3页China Journal of Chinese Ophthalmology

摘　　要：目的探讨连续环行撕囊(continuous curvilinear capsulotomy,CCC)及手法碎核小切口技术在白内障囊外摘出(extra-capsular cataract extraction,ECCE)联合人工晶状体(instraocular lens,IOL)植入术中的优缺点,改进手术方法,提高手术质量和效果。方法54例58只眼采用CCC及手法碎核施行小切口白内障囊外摘出联合IOL植入,26例26只眼采用常规开罐式截囊(can-opener capsulotomy,COC)及大切口白内障囊外摘除联合IOL植入。结果小切口CCC手法碎核组术后1周矫正视力≥0.4者占82.7%,12周后占96.0%。术后1周平均散光为1.56±0.88 D,术后12周为0.76±0.56 D。分别小于同期内施行的大切口COC对照组(P<0.001),并发症少于对照组(P<0.01)。结论连续环行撕囊及手法碎核行小切口白内障手术可明显减少术后散光及并发症,确保IOL植入囊袋中,减少IOL植入睫状沟后的并发症,避免了IOL的倾斜、偏位,相当程度地提高了ECCE和IOL植入术的质量和效果。OBJECTIVE To discuss advantages and disadvantages of continuous curvilinear capsulotomy （CCC） and manual nucleus division in extra- capsula cataract extraction （ECCE） and instraocular lens （IOL） implantation. To improve operation method and the quality and effect of operation. METHODS Extracapsula cataract extrac- tion and instraocular lens implantation with continuous curvilinear capsulotomy and manual nucleus division and small incision technique was performed on 58 eyes of 54 patients. Extra - capsula cataract extraction and instraocular lens implantation with routine can - opener capsulotomy and large incision technique was performed on 26 eyes of 26 patients. RESULTS Post - operatively, the visual acuities were 0.4 on better in 82.7 % at one week and in 96.0 % at 12 weeks in the CCC and manual nucleus division group. The mean post - operative astigmatism was 1.56 ±0.88 D at one week and 0.76 ± 0.56 D at 12 weeks which was less than that in the control group of COC and large incision ECCE performed in the same period and compared at the same times respectively （P 〈 0.001）, and the complications were less than that in the control group （ P 〈 0.01 ） . CONCLUSIONS CCC and manual nucleus division and small incision technique used in ECCE can reduce the post- operative astigmatism and complications evidently, increase the success rate of in - bag implantation and reduce ciliary sulcus implantation - induced postoperative complications, avoid IOL sloping and eccentricity, improve the quality and effect of ECCE and IOL implantation at comparative extent.

关 键 词：小切口 手法碎核 连续环行撕囊 白内障摘出术 人工晶状体 

分 类 号：R779.66[医药卫生—眼科]