从小切口白内障囊外摘除过渡到超声乳化200余例临床体会

摘要

Objective To evaluate the safeness and effectiveness transiting from manual nucleus division to phacoemulsi-fication. Methods Through the theory study of phacoemulsification cataract extraction and understand to the instrument, analyze the complication in and after operation , visual acuity , nodus in the first 200 cases (223 eyes) after the introduction of phacoemulsification instrument. Results Completing capsulorhexis in 217 eyes, there are 11 eyes of posterior capsular rupture, 3 of them are chanced to extracapsular extraction. Intraocular lens are implanted synchronized in 221 eyes,216 eyes in capsule, 5 eyes in ciliary groove. Secondary implantation of anterior chamber intraocular lens in 2 eyes, 1 eye has posterior capsular rupture, 1 eye has capsule extract completely. Using I/A to remove cortex thoroughly in 101 eyes, change to other methods in 122 eyes; comeal edema are observed with slit lamp microscope in 63 eyes, 1 of them has not regressed in 7 days, after 30 days, the comeal is transparent basically. In 149 eyes, the naked vision ≥0. 5 at the first day after the operation. Conclusion Through the theory study, one can transit to phacoemulsification smoothly form adroit small incision cataract extraction.%目的 评价从手法碎核小切口白内障摘除过渡到白内障超声乳化的安全性及有效性.方法 通过对白内障超声乳化技术理论的自学和对超声乳化仪的了解,对引进白内障超声乳化仪后最初开展的200余例(223眼)白内障超声乳化摘除术中的难点,患者术中、术后并发症、术后视力等进行分析.结果 完成撕囊217眼,术中后囊膜破裂11眼,改为囊外摘除3眼.同期植入后房人工晶体221眼,其中囊袋内216眼,睫状沟5眼,Ⅱ期植入前房型人工晶体2眼,其中后囊膜破裂1眼,囊袋完全吸出1眼.超乳I/A完全清除皮质101眼,改用其他方法122眼；术后裂隙灯下可见角膜水肿63眼,7d后水肿未消的1眼,30d后角膜基本透明.术后第1天裸眼视力≥0.5的患者149眼.结论 通过理论学习,可以在熟练的小切口白内障摘除基础上比较顺利的过渡到超声乳化白内障摘除.