改良亚甲蓝和台盼蓝前囊染色在白色白内障撕囊术中的临床应用对比  

A comparative clinical study of anterior capsule staining for capsulohexis in cases of whit cataract with methylene blue and trypan blue

作　　者：孙丽霞[1] 张文一[1] 刘卫真[2] 程华[1] 

机构地区：[1]青岛大学医学院附属医院眼科,山东青岛266003 [2]青岛大学医学院附属医院海阳分院眼科,山东海阳265100

出　　处：《眼外伤职业眼病杂志》2008年第5期351-354,共4页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的探讨晶状体超声乳化术中改良亚甲蓝染色和台盼蓝染色对连续环形撕囊成功率及对角膜内皮的影响。方法67例(67眼)白色白内障(术中无红光反射者)随机分为3组进行前瞻性研究。改良亚甲蓝染色组25例,台盼蓝染色组24例,对照组(前囊不染色)18例。连续环形撕囊后行超声乳化及人工晶状体植入术。比较环形撕囊成功率、术中并发症、术后前房反应情况、视力、眼压、角膜内皮损失率及变异系数。结果两种方法染色后撕囊成功率及人工晶状体囊袋内植入率均为100.00%,无后囊破裂,与对照组相比差异有统计学意义;染色组术后视力高于对照组,但差异无统计学意义;3组术后眼压及角膜内皮损失率和变异系数差异均无统计学意义。结论改良亚甲蓝染色和台盼蓝染色均可明显提高连续环形撕囊成功率,降低超声乳化手术并发症,且无明显副作用,前者廉价易得,使用效果与台盼蓝相同。Objective To compare the safety and efficacy of methylene blue 1% and trypan blue 0.1% for anterior capsule staining for capsulorhexis in cases of white cataract, as well as the influence to the endothelial cells of cornea. Methods sixteen-seven eyes of 67 patients with age-related white cataract were engaged in this study, the anterior chamber membrane of 25 cases were stained with a reformative method of methylene blue 1% under Sodium hya- luronate, 24 cases had anterior capsule staining with trypan blue 0.1% under an air bubble, 18 cases had not stained, and then all the cases followed by continuous curvilinear capsulorhexis （CCC） and phacoemulsification with foldable intraocular lens implantation. The results of creating a continuous curvilinear capsulorhexis （CCC） and the appearances of complications during the surgery were noted. Postoperative examinations at 1 day, 1 week, and 1 month included slit lamp microscopy and hest corrected visual acuity （BCVA）. The intraocular pressure （IOP） was assessed at 1 day and the density as well as the coefficient of variation of the cornea endothelial cells was counted at 1 month after operation. Results The surgeon had best visualization during the anterior capsulorhexis with methylene blue and trypan blue staining, and a complete CCC was achieved in all eyes of the stained groups. All eyes achieved a BCVA of 0.6 or better from 1 week postoperatively to the last follow-up. The lOP, the loss and coefficients of variation of corneal endothelial cells were comparable between the groups. Conclusions Methylene blue and trypan blue were both safe and effective in staining the anterior capsule for phacoemulsification in eyes with white cataract, the latter may be particularly suited for use in developing countries as it is cost effective and easily available even at primary helth centers.

关 键 词：白内障 晶状体超声乳化 连续环形撕囊 囊染色 

分 类 号：R779.66[医药卫生—眼科]