硬核白内障3．2mm小切口核周碎核技术的应用观察  

Clinical application of the 3.2 mm small incision in hard nuclear cataract surgery with the manual chopping around nuclear technique

作　　者：黄永建[1] 钟守国[2] 黄栋才[1] 

机构地区：[1]峨眉山市人民医院眼科,四川峨眉山614200 [2]四川省人民医院眼科,四川成都610075

出　　处：《中医眼耳鼻喉杂志》2014年第3期132-134,共3页Journal of Chinese Ophthalmology and Otorhinolaryngology

摘　　要：目的探讨硬核白内障3．2mm小切口核周劈核技术的临床效果。方法实验组为61例68眼硬核老年性性白内障（Ⅳ级核57眼，Ⅴ级核11眼），均对其行3．2mm带球结膜的角巩膜缘遂道式切口的手法碎核摘除术，先行较软部分核周逐块劈开粉碎刨出，待大部核周劈开粉碎刨出后将核心旋转刨出或劈开后刨出，最后植入折叠式人工晶状体。对照组为153例168眼硬核老年性性白内障（Ⅳ级核116眼，Ⅴ级核52眼），行3．5～3．8mm中央手法劈核摘除术后植入折叠人工晶体。对比观察两组术中、术后并发症及术后视力变化。结果实验组术中后囊破裂1眼占1．47％，角膜水肿14眼占20．5％，对照组术中后囊破裂5眼占3％，角膜水肿55眼占33％，两组比较差异有统计学意义（P〈0．05）。术后第一周视力大于或等于0．5占65．9％，一月视力大于或等于0．5占87．2％．对照组术后第一周视力大于或等于0．5占57．14％，一月视力大于或等于0．5占82．74％，两组间差异也有统计学意义（P〈0．05）。结论对Ⅳ-Ⅴ级核硬核行核周劈核粉碎摘除术可减少切口大小，提高手术效果并可减少术中，术后并发症。Objection To discuss the clinical effect of 3.2mm small incision in hard nuclear cataract surgery with the nuclear chopped around technique. Methods 61 patients （ 68 eye, hardness of nucleus was of grade 4 in 57 eyes, grade 5 in 11 eyes ） were performed cataract extraction with the manual nucleus chopping technique , through 3.2ram tunnel incision on the superior 2m limbus, followed the soft partial of hard nucleus would be chopped first, then center of hard nucleus were rotated or divided into pieces for remove, last foldable intraoeular lens were implanted in. Another 153 cases （168 eyes, hardness of nucleus was of grade 4 in 116 eyes, grade 5 in 52 eyes ） were set into the control group, which were performed manual nucleus division directly , after 3. 5 - 3. 8mm limbus tunnel incision made. Intra-operative and postoperative complications , postoperative visual acuity would be investigated. Results Posterior capsule rupture in 1 eyes （1.46%） and corneal edema in 14 eyes （20.5%） occurred in experimental group ,which in control group were 5 eyes （3%） and 55 eyes respectively, there were significant difference between both group in two indexes above（P〈0.05）. The visual acuity of experimental group was better than 0.5 in 65. 9% one week after operation, and was better than 0.5 in 87.2% one month, compared to 57.14% and 82. 74% in control group, there were also significant difference between two groups（P〈0.05）. Conclusions The manual small incision cataract with manual nuclear chopped around technique for grade 4,5 nucleus can gain smaller incision,better clinical effects and reduce the intra-operative postoperative complications.

关 键 词：小切口 白内障摘除术 手法劈核 

分 类 号：R776.1[医药卫生—眼科]