葡萄膜炎并发白内障术中使用Chop钩象限性机械扩张瞳孔的效果  

Effect of quadrant mechanical pupillary dilatation of Chop hooks during surgery of uveitis complicated cataract

作　　者：陈子扬 曹俊昌 叶照达 陈胜[2] 胡艳红[2] Zi-Yang Chen;Jun-Chang Cao;Zhao-Da Ye;Sheng Chen;Yan-Hong Hu(Fujian Academy of Chinese Medical Sciences Chinese Medicine Clinic,Fuzhou 350003,Fujian Province,China;Department of Ophthalmology,the Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine,Fuzhou 350003,Fujian Province,China)

机构地区：[1]福建省中医药科学院综合门诊部,福建福州350003 [2]福建中医药大学附属第二人民医院眼科,福建福州350003

出　　处：《国际眼科杂志》2022年第12期1943-1947,共5页International Eye Science

摘　　要：目的:报道在葡萄膜炎并发白内障患者的白内障手术中使用一种特殊的Chop钩象限性机械扩张瞳孔的手术效果。方法:单手术、回顾性、非比较病例报道。纳入在白内障术中接受Chop钩象限性机械扩张瞳孔特殊技术治疗的葡萄膜炎并发白内障患者。结果:共14例葡萄膜炎并发白内障患者16眼,男性5例,女性9例,平均年龄58.0±13.8(29~79)岁,在白内障手术中接受Chop钩象限性机械扩张瞳孔治疗。采用象限性机械瞳孔扩张后,扩张瞳孔直径为5.81±0.46(5.0~6.5)mm,并可保持至手术结束。术后,瞳孔居中,约为圆形,瞳孔直径为3.0~4.0mm。在某些情况下,在虹膜和瞳孔的边缘观察到小切迹,但患者没有出现眩光不适,直接和间接的光反射大致正常。散瞳孔治疗后,瞳孔变圆,与人工晶状体无粘连,术后最佳矫正视力(BCVA)明显优于术前(P<0.01)。术中及术后随访期间未观察到严重的并发症,如悬韧带断裂、囊膜边缘破裂、前房积血、前葡萄膜炎复发、角膜水肿、眼压升高(IOP>21mmHg)、虹膜撕裂、虹膜异常、后粘连。结论:该象限机械瞳孔扩张技术对于葡萄膜炎并发白内障患者是一种简单有效的白内障手术方法,且并发症发生率低。AIM:To report the surgical effects of using a special Chop hooks technique to dilate the pupils during cataract surgery of patients with uveitis complicated cataract.METHODS:A single-surgeon,retrospective,non-comparative case report.All patients with uveitis complicated cataract who were treated with quadrant mechanical pupillary dilatation of Chop hooks were included.RESULTS:A total of 16 eyes of 14 patients(with 5 males,9 females and a mean age of 58.0±13.8 years old;range:29-79 years old)underwent mechanical pupillary dilatation of Chop hooks during cataract surgery.After using quadrant mechanical pupillary dilatation,the dilated pupil diameter was 5.81±0.46(range:5.0-6.5)mm,and the size was maintained until the end of the operation.After the operation,the pupils were centered and approximately round,and the diameter of the pupils was 3.0-4.0 mm.In some cases,small notches were observed at the edge of the iris and pupil.However,the patients had no complaints of glare.Direct and indirect light reflections were roughly normal.After mydriasis treatment,the pupils became round and did not adhere to the intraocular lens,and the postoperative best-corrected visual acuity(BCVA)was significantly better than that before surgery(P<0.01).No serious intraoperative or postoperative complications,including zonular fiber rupture,capsular rim rupture,hyphema,anterior uveitis,corneal edema,raised intraocular pressure(IOP>21 mmHg),iris tearing,iris abnormalities and posterior synechiae,were observed during the follow-up period.CONCLUSION:With low incidence of complication,the technique of quadrant mechanical pupillary dilatation is a simple and effective procedure for cataract surgery in patients with uveitis complicated cataract.

关 键 词：瞳孔 扩张 葡萄膜炎 并发性白内障 

分 类 号：R773[医药卫生—眼科] R779.66[医药卫生—临床医学]