连续环形撕囊制作大直径前囊口在手法无缝线白内障囊外摘出术中的应用  

Continuous curvilinear capsulorhexis of large size in manual sutureless extracapsular cataract extraction

作　　者：曾原[1] 邓江稳 

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

出　　处：《眼科新进展》2014年第8期748-750,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨以连续环行撕囊方法制作大直径前囊口在手法无缝线白内障囊外摘出术中的安全性及有效性。方法采用手法无缝线白内障囊外摘出术对五三五医院住院的1443例（1965眼）白内障患者进行手术,术中采用连续环行撕囊法制作直径7~8 mm的前囊口,对患者术中撕囊是否成功、有无后囊破裂、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 1942眼（98.8%）连续撕囊成功;15眼（0.8%）囊膜瓣向周边撕裂不能挽救,留有放射状裂口1个;8眼（0.4%）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等并发症发生,并顺利植入人工晶状体。术后一过性角膜水肿36眼（1.8%）,术后90 d视力〉0.5者1674眼（85.2%）,〉0.3者1878眼（95.6%）。结论在手法白内障术中用连续环形撕囊方法制作大于常规直径的前囊口,使手术安全性提高,值得推广和应用。Objective To evaluate the efficacy and safety of continuous curvilinear capsulorhexis（ CCC） in large size in manual sutureless extracapsular cataract extraction（ ECCE）. Methods The clinical data of 1443 patients（ 1965 eyes） who underwent ECCE in which large continuous curvilinear capsulorhexis（ 7- 8 mm） were performed were analyzed,the related complications such as capsule rupture, corneal edema and visual conditions were statistically analyzed and compared. Results In 1942 eyes（ 98. 8%）,CCC with large size were performed successfully; In15 eyes（ 0. 8%）,a radial tear which could not be saved was left when a CCC performed; In 8eyes（ 0. 4%）,a CCC could not be done due to calcification of the anterior capsule. No posterior capsular rupture occurred. All eyes were implanted with IOL in the posterior chamber successfully.The incidence of transient corneal edema was 1. 8%（ 36 eyes）. The visual acuity in 1674 eyes（ 85. 2%） were equal to or more than 0. 5 and 1878 eyes（ 95. 6%） were equal to or more than0. 3 at postoperative 90 days. Conclusion Large CCC technique for manual sutureless ECCE is safe and reliable, and worthy of application in basic medical institutions.

关 键 词：连续环形撕囊 手法无缝线白内障囊外摘出术 脱核 后囊破裂 角膜水肿 

分 类 号：R776.1[医药卫生—眼科]