病理性大瞳孔下显微小撕囊口白内障超声乳化术临床研究  

Phacoemulsification through a small continuous circular capsulotomy in eye with pathologic large pupil

作　　者：李韵倩[1] 王剑锋[1] 方丽[1] 

机构地区：[1]安徽省蚌埠医学院附属医院眼科,233004

出　　处：《临床眼科杂志》2008年第2期144-146,共3页Journal of Clinical Ophthalmology

摘　　要：目的探讨对于瞳孔呈麻痹性或粘连性散大状态(直径≥5mm)的白内障患者,如何利用显微手术技术,在小直径的连续环形撕囊口内进行白内障超声乳化手术,待残余的前囊膜增生混浊后形成人造小瞳孔,消除像差等干扰,提高视觉质量。方法对51例(63只眼)瞳孔呈病理性散大的白内障患者,手术显微镜下做直径小于4mm的连续环形撕囊。在囊袋内采用高负压吸引,原位拦截劈核法,完成白内障超声乳化手术。囊袋内植入人工晶状体。结果术后经过3个月以上的随访,残余的囊袋前膜增生混浊,形成一层不透明的白色机化膜,撕囊口缩小至3mm左右,患者的视力在原发病的基础上有不同程度的提高。结论对于存在病理性大瞳孔的白内障患者,借助于精细的显微镜手术技巧和超声乳化技术,完成小撕囊口内的白内障超声乳化手术。利用日后混浊的前囊膜代替虹膜,形成人造小瞳孔,是使患者在脱盲的基础上提高视觉质量的一种安全、有效的方法。Objective To assess the microsurgical techniques and clinical effect of phacoemulsification thrkugh a small opening in the anterior capsule of lens in eye with palsied or adhesive large pupil （≥5mm in diameter） . The remains of the anterior capsule gradually became opacified and an artificial small pupil was formed . Methods On 51 case （63 eyes） with pathologic large pupils, continuous circular capsulotomy （CCC） of 4mm in diameter was made under surgical microscope . And phacoemulsification with high-vaccum stop and chop style was performed into the capsular bags . Result After more than three months＇ postoperative follow-up, the anterior capsule proliferated into a thick opacified membrane covering the lens , leaving an artificial small pupil only about 3mm in diameter in the center because of the shrinkage of the capsule. The visual acuity was improved. Conclusion For catauact patient with pathologic large pupil, phacoemulsification through a small CCC was an effective method to avoid photkphobia, and make patients to see more comfortably.

关 键 词：病理性大瞳孔 小口径连续环形撕囊 白内障超声乳化 

分 类 号：R779.66[医药卫生—眼科]