无灌注超乳针头截囊减张法在膨胀性白色白内障手术中的应用  

Application of nonperfusion phacoemulsification needle capsulotomy decompression method in intumescent white cataract surgery

作　　者：徐旭亚 李艳艳 徐俊钊 Xu Xuya;Li Yanyan;Xu Junzhao(Department of Ophthalmology,People’s Hospital of Baofeng County,Henan 467400,China)

机构地区：[1]宝丰县人民医院眼科,河南467400

出　　处：《中华眼外伤职业眼病杂志》2021年第3期236-240,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的观察应用无灌注超乳针头截囊减张法治疗膨胀性白色白内障的效果。方法回顾性分析宝丰县人民医院2017年1月至2020年2月膨胀性白色白内障315例(340眼)的临床资料。所有患者按手术方式分为两组:常规组,常规撕囊法手术69例(82眼);减张组,采用无灌注超乳针头截囊减张法撕囊手术246例(258眼)。观察两组术后视力、并发症和撕囊成功率。结果常规组有13眼(15.85%)晶状体囊裂开,其中1眼后囊破裂、玻璃体脱出,改行白内障囊外摘出术,2眼人工晶状体睫状沟植入;减张组有15眼(5.81%)囊裂开,使用囊剪完成撕囊,未影响超声乳化操作,均囊袋内植入人工晶状体。减张组撕囊成功率94.19%(243/258),高于常规组的84.15%(69/82)(χ^(2)=8.299,P=0.004)。结论无灌注超乳针头截囊减张法能解决膨胀性白色白内障高张力和皮质溢出问题,提高撕囊成功率。Objective To observe the application efficacy of nonperfusion phacoemulsification needle capsulotomy decompression method in intumescent white cataract surgery.Methods This was a retrospective study.The clinical data of 340 eyes of 315 patients with intumescent white cataract from Jan.2017 to Feb.2020 in People’s Hospital of Baofeng County were collected.All cases were devided into two groups based on surgical methods,82 eyes of 69 cases received continuous curvilinear capsulorhexis(CCC)in the conventional group,and 258 eyes of 246 cases received nonperfusion CCC with phacoemulsification needle capsulotomy decompression method in decompression group.The visual acuity,complication and successful rate after surgery in the two groups were observed.Results The capsule blast occurred in 13 eyes(15.85%)in the conventional group.Among them 1 eye with posterior capsule rupture and vitreous prelapse in the conventional group recevid extracapsular lens extraction.The intraocular lens were implanted in ciliary sulcus in 2 eyes.In the decompression group,the capsule blast occurred in 15 eyes(5.81%),then extended the curvilinear capsulorhexis with the forceps,all the cases completed phacoemulsification combined with intraocular lens implanted in capsular bag.The successful rate of the decompression group(94.19%,243/258)was higher than that of the conventional group(84.15%,69/82).The difference in the successful rate was statistically significant between the two groups(χ^(2)=8.299,P=0.004).Conclusion Application of nonperfusion phacoemulsification needle capsulotomy decompression method in intumescent white cataract surgery can reduce the pressure in capsular bag,avoid lens cortex overflow,and improve the success rate of capsulorhexis.

关 键 词：白内障 白色 膨胀性 乳化 晶状体 超声 撕囊术 减张法 截囊 超乳针头 无灌注 

分 类 号：R779.66[医药卫生—眼科]