初学者超声乳化白内障手术1000只眼的体会  

Experience of phacoemulsification cataract surgery in 1000 eyes for beginner

作　　者：代雨岑 盘如刚 姚莎莎[2] 甘春芳 DAI Yucen;PAN Rugang;YAO Shasha;GAN Chunfang(Department of Ophthalmology,The Affiliated Hospital of Southwest Medical University,Luzhou 646000,China;Department of Ophthalmology,Ya'an People's Hospital,Ya'an 625000,China)

机构地区：[1]西南医科大学附属医院眼科,四川省泸州市646000 [2]雅安市人民医院眼科,四川省雅安市625000

出　　处：《中国实用眼科杂志》2018年第4期303-306,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的对初学者开展白内障超声乳化手术766例(1000只眼)进行回顾性分析总结。方法对1000只眼白内障超声乳化及人工晶状体植入术进行分析研究,总结并发症及其处理方法和超声乳化能量(CDE)运用变化规律。结果并发症主要发生于前50只眼手术:3只眼(0.3%)V级核患者未完成超声乳化转为小切口ECCE;后囊膜破裂9只眼(0.9%),通过切割前段玻璃体、睫状沟植入I0L;囊膜撕裂16只眼(1.6%),通过从反向撕囊予以解决;主切口区角膜后弹力层部分损伤34只眼(3.4%),其中角膜后弹力层脱离3只眼,通过前房注人消毒空气恢复;虹膜损伤5只眼(0.5%)。前、中、后期各50只眼I级核患者超声乳化能量(CDE)比较有明显递减趋势。结论对于初学者开展白内障超声乳化手术应注意:要有熟练的小切口ECCE经验,有上级医师指导(最好能参与正规的超声乳化培训),对设备熟练掌握,减少器械进出前房次数和使用锋利穿剌刀做切口,注意手术初期患者的选择,熟练掌握各种并发症的处理。Objective 766 Cas es(1000 eyes)of cataract phacoemulsification for beginners were retrospectively analyzed.Methods The analysis of 1000 eyes phacoetmulsification and intraocular lens implantation was carried out to summarize the complications and their treatment methods and the changes in the application of phacoemulsification energy(CDE).Results Complications occurred mainly in 50 eyes before operation:3 eyes(0.3%)had not completed phacoemulsification to small incision ECCE;Posterior capsular rupture occurred in 9 eyes(0.9%),and IOL was implanted in ciliary sulcus by cutting anterior vitreous;Capsular tear in 16 eyes(1.6%),be solved by capsularhexis from the reverse;34 cases(3.4%)of corneal posterior elastic layer were damaged in main incision area and were recovered by sterilized air through anterior chamber,and of which 3 eyes have a detachment;5 eyes iris injury(0.5%).The phacoemulsification energy(CDE)in the first,middle and late stage of 50 eyes with stage III nucleus was obviously decreasing.Conclusions Attention should be paid to cataract phacoemulsification for beginners:have a skilled small incision ECCE experience,with a superior physician guidance(it is best to be able to participate in regular phacoemulsification training),we should master the equipment well,reduce the number of instruments entering and leaving the anterior chamber and use sharp tools to make incisions,pay attention to the selection of patients at the early stage of operation,master the treatment of all kinds of complications.

关 键 词：白内障 超声乳化 初学者 

分 类 号：R77[医药卫生—眼科]