玻璃体晶状体切除术手术技巧的优化  

The modification of surgical technique of vitrolensectomy

作　　者：席向莹 秦廷玉[1] 高莎莎[1] 王文战[1] Xi Xiangying;Qin Tingyu;Gao Shasha;Wang Wenzhan(Department of Ophthalmology,The First Affiliated Hospital of Zhengzhou University,Henan Provincial Ophthalmic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院眼科,河南省眼科医院,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2021年第9期706-710,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：河南省高等学校重点科研项目计划(19A320059,19A320078);河南省卫生计生科技英才海外研修工程(2018033,2018054);河南省科技厅2018年度重点研发与推广专项(1455);河南省卫生计生委医学科技攻关项目(201403055,201503056)。

摘　　要：目的探讨玻璃体晶状体切除术手术技巧优化的特点。方法回顾性研究。分析郑州大学第一附属医院2015年1月至2020年9月增生型糖尿病性视网膜病变伴发白内障103例(103眼)的临床资料。患者分为两组:A组,59眼经睫状体平坦部巩膜穿刺口切除晶状体后囊后,先进行水分离和水分层,再用玻切头切除晶状体;B组,对照组,44眼,不进行水分离和水分层,直接用玻切头切除晶状体,观察两组手术耗时及并发症。结果A组切除晶状体耗时(5.68±1.20)min短于B组的(10.16±1.98)min(t=14.277,P<0.001);A组术中晶状体前囊破裂者1眼(1.69%)少于B组的8眼(18.18%)(χ^(2)=6.648,P=0.010)。结论晶状体玻璃体切除术中先行水分离再切除晶状体手术耗时短,前囊破裂率低。Objective To investigate the feature of modified surgical technique of vitrolensectomy.Methods This was a retrospective study.The clinical data of 103 eyes of 103 patients with proliferative diabetic retinopathy(PDR)and cataract from Jan.2015 to Sept.2020 in the First Affiliated Hospital of Zhengzhou University were analyzed.All cases were divided into clinical trial group and control group.After resecting posterior lens capsule via pars plana scleral incision,the clinical trial group with 59 eyes as group A,received hydrodissection and stratification firstly and then lensectomy with vitrectomy apparatus.The control group with 44 eyes as group B,received the vitrolensectomy without hydrodissection or stratification.The surgical time and complications of two groups were observed.Results The time of lensectomy in group A was(5.68±1.20)minutes,which was shorter than(10.16±1.98)minutes of group B(t=14.277,P<0.001).During the surgery in group A,the rupture of the anterior capsule occurred in 1 eyes(1.69%),which was less than 8 eyes(18.18%)in group B(x^(2)=6.648,P=0.010).Conclusion During vitrolensectomy,hydrodissection and stratification firstly can shorten the time of lensectomy and reduce the incidence of the anterior capsule rupture.

关 键 词：玻璃体晶状体切除术 水分离 手术技巧 优化 

分 类 号：R779.6[医药卫生—眼科]