手法小切口白内障术中累及悬韧带区的连续环形撕囊的安全性探讨  

Continuous curvilinear capsulorhexis involving zonular area in manual small incision cataract surgery

作　　者：高建华[1] 邓江稳 曾原[1] 

机构地区：[1]成都军区昆明总医院眼科,中国云南省昆明市650032 [2]解放军五三五医院眼科,中国湖南省怀化市418008

出　　处：《国际眼科杂志》2014年第6期1145-1147,共3页International Eye Science

摘　　要：目的：探讨在手法小切口白内障术中超出无悬韧带区域的连续环形撕囊的安全性及有效性。方法：采用手法无缝线白内障囊外摘除术对住院1 443例1 965眼白内障患者进行手术，术中采用连续环形撕囊法制作7～8mm直径前囊口，对患者术中撕囊是否成功、后囊破裂、术后角膜水肿及视力等情况进行统计学分析，研究其手术价值。结果：患者1 965眼中，1 942眼（98.83%）连续撕囊成功； 15眼（0.76%）囊膜瓣向周边撕裂不能挽救，留有放射状裂口一个； 8眼（0.41%）因为囊膜钙化机化等原因无法常规撕囊，采用囊膜剪开及截囊等方法完成前囊开口。所有病例，均无后囊破裂发生，并顺利植入人工晶状体。术后一过性角膜水肿36眼（1.83%）。术后1d，视力≥0.5者1 650眼（83.97%），≥0.3者1 867眼（95.01%）。人工晶状体位置正并且稳定。结论：在手法白内障术中用连续环形撕囊方法制作累及悬韧带区域的大于常规直径的前囊口，并未降低囊袋和人工晶状体的稳定性，使手术安全性提高，值得推广和应用。AIM： To evaluate the efficacy and safety of large sized continuous curvilinear capsulorhexis（CCC）involving zonular area in manual small incision cataract surgery（MSICS）. METHODS：Totally 1 443 cataract patients（1 965 eyes）underwent MSICS, in which large CCC up to 7-8mm were performed.The related conditions such as success rate of performing CCC, capsule rupture, corneal edema and visual acuity after surgery were recorded and statistically analyzed.RESULTS：In total of 1 965 eyes, 1 942 eyes（98.83%）had successful CCC, 15 eyes（0.76%）had a radial tear which could not be saved when performing CCC, 8 eyes（0.41%）had anterior capsule opened with a cystotome or a scissor due to capsule membrane calcification. No posterior capsule rupture occurred, and intraocular lens was transplanted in all cases. Transient corneal edema was noted in 36 eyes（1.83%）. One day after surgery, 1 650 eyes（83.97%）had visual acuity ≥0.5, 1 867 eyes（95.01%）≥0.3. No unstable intraocular lens was noted in all cases. CONCLUSION： Large CCC technique for MSICS is safe and reliable,not decreasing stability capsular bag and intraocular lens. It is of high originality despite zonular area is involved so that it is worthy of application in basic medical institutions.

关 键 词：连续环形撕囊 悬韧带 手法小切口白内障手术 脱核 

分 类 号：R779.66[医药卫生—眼科]