反式劈核钩预劈核技术在白内障超声乳化摘除术中的应用  

Application of the Prechop Technique Using a Reverse Chopper in Phacoemulsification of Cataract

作　　者：陈舒萍 卓萍萍 韩佳敏 张钰涵 黄先武 CHEN Shuping;ZHUO Pingping;HAN Jiamin;ZHANG Yuhan;HUANG Xianwu(Department of Ophthalmology,Changle District People’s Hospital,Fuzhou,Fujian 350200,China)

机构地区：[1]福建省福州市长乐区人民医院眼科,福州福建350200

出　　处：《中国医药指南》2025年第9期78-80,共3页Guide of China Medicine

摘　　要：目的分析反式劈核钩预劈核技术在白内障超声乳化摘除术中的应用效果。方法回顾性分析2021年1月至2023年3月于本院应用反式劈核钩预劈核技术行白内障超声乳化手术的患者,观察术后第1天角膜水肿情况、术后最佳矫正视力(BCVA)及术中、术后并发症,并分析术后角膜水肿相关影响因素。结果共收集到657例患者802只眼。依据Emery分级,Ⅱ级核有258眼(32.17%),Ⅲ级核369眼(46.01%),Ⅳ级核136眼(16.96%),Ⅴ级核39眼(4.86%)。术后第1天角膜水肿程度分级,0级占90.90%(729眼),1级占7.86%(63眼),2级占1.12%(9眼),3级仅0.12%(1眼)。术后第1天发生角膜水肿占9.10%(73眼)。术后第1天BCVA≤0.3者88眼(10.97%),0.4~0.7者271眼(33.79%),≥0.8者443眼(55.24%)。1例(0.12%)膨胀型白核在预劈核时发生后囊膜破裂,其余术中及术后均无严重并发症发生。结论反式劈核钩预劈核技术应用于白内障超声乳化摘除术效果良好。术后角膜水肿轻,核硬度分级会影响术后角膜水肿的发生,术后视力恢复快,术中及术后基本无并发症发生。Objective To analyze the effect of the prechop technique using a reverse chopper in phacoemulsification of cataract.Methods Retrospective analysis was performed on patients undergoing cataract phacoemulsification with trans-cleft hook pre-cleft technique in our hospital from January 2021 to March 2023.Corneal edema,Best corrected visual acuity(BCVA),intraoperative and postoperative complications were observed on the first day after surgery,and the related influencing factors of corneal edema were analyzed.Results A total of 802 eyes were collected from 657 patients.According to the Emery classification,there were 258 eyes(32.17%)of gradeⅡ,369 eyes(46.01%)of gradeⅢ,136 eyes(16.96%)of gradeⅣ,and 39 eyes(4.86%)of gradeⅤ.The degree of corneal edema on the first day after surgery was 90.90%(729 eyes)in grade 0,7.86%(63 eyes)in grade 1,1.12%(9 eyes)in grade 2,and only 0.12%(1 eye)in grade 3.Corneal edema occurred in 9.10%(73 eyes)of patients on the first day after surgery.On the first day after surgery,BCVA≤0.3 in 88 eyes(10.97%),0.4-0.7 in 271 eyes(33.79%),and≥0.8 in 443 eyes(55.24%).Posterior capsule rupture occurred in 1 case(0.12%)with dilatated white nucleus during prechop,and no serious complications occurred in other cases.Conclusions The trans-cleft hook pre-cleft technique has good effect in phacoemulsification of cataract.Postoperative corneal edema is mild,the hardness grade of nuclear will affect the occurrence of postoperative corneal edema,postoperative vision recovery is rapid,and there are basically no complications during and after the operation.

关 键 词：反式劈核钩 预劈核 白内障超声乳化 角膜水肿 核分级 影响因素 

分 类 号：R776.1[医药卫生—眼科]