超声乳化技术在超低密度角膜内皮白内障手术中的应用探讨  

Application of technique in cataract phacoemulsification surgery of ultra low density corneal endothelium

作　　者：尹源源 施玉英[2] 张小建 黎宁 王燕 

机构地区：[1]北京市华德眼科医院,北京100026 [2]北京市同仁医院,北京100730

出　　处：《东南国防医药》2016年第4期393-394,401,共3页Military Medical Journal of Southeast China

摘　　要：目的探讨超低密度角膜内皮白内障患者行超声乳化手术中的技术要点。方法对13例(16只眼)角膜内皮计数<1000/mm2的白内障患者行超声乳化吸除及人工晶体植入术。其中角膜内皮细胞密度为660~800/mm^2的2眼,800~900/mm^2的9眼,900~1000/mm^2的5眼,Ⅱ级核5眼,Ⅲ级核8眼,Ⅳ级核3眼。均进行超声乳化吸出及人工晶体植入术,术中将眼内压平衡技术、软壳技术及水平劈核技术相结合。结果术后视力均有不同程度提高,无角膜失代偿者。角膜内皮细胞丢失率在(6.2±2.3)%。结论超低密度角膜内皮不再是白内障手术的禁区,依靠谨慎地操作和熟练的技巧,仍可以获得良好的效果。Objective To investigate the key points of phacoemulsification in cataract patients with ultra low density corneal endothelium. Methods Phacoemulsification and intraocular lens implantation were performed in 13 patients （ 16 eyes） with corneal endothelium count 〈1000/mm2 . The corneal endothelial cell density was 660~800/mm2 in 2 cases, 800~900/mm2 in 9 cases, and 900~1000/mm2 in 5 cases, Class II nucleus in 5 cases, grade III in 8 cases, grade IV in 3 cases. All eyes underwent phacoemulsifica-tion and intraocular lens implantation. In the operation, the intraocular pressure balance technique, the Duovisco viscoelastic soft shell technique and the technique of horizontal nuclear chopping in situ ultrasound were combined. Results Postoperative visual acuity was improved in different degree, without corneal loss of compensation. The loss rate of corneal endothelial cells was 6.2% ±2.3%. Conclu-sion Ultra low density of corneal endothelium is no longer restricted in cataract surgery by careful operation and skill, and can still get a good curative effect.

关 键 词：超低密度角膜内皮 超声乳化 软壳技术 水平劈核 

分 类 号：R776.1[医药卫生—眼科]