撕囊术的重新评价:撕囊术中的撕裂角度(英文)

A reappraisal of the capsulorhexis:tearing angle in capsulorhexis

目的:针对不同材料及连续环形撕囊术中人晶状体囊,测量其撕裂角度和力度,并评价所产生的压力。方法:通过用钝针头撕裂不同的材料,例如铝薄纸、多种薄层移植修复材料以及人晶状体囊,测量撕裂角度和作用力方向,评价在此过程中上述可撕裂材料表面所潜在增加的压力,以及在不同年龄(10～17岁)24只尸体眼中对前房深度和玻璃体压力所产生的影响。结果:每种材料所产生的撕裂角度是唯一的,随着年龄的增长其撕裂角度和力度反而降低(从10岁的85°到50岁以上的10°)。增加的玻璃体压力和降低的前房深度导致了撕裂点的高压力。在本文中讨论了连续环形撕囊术中安全的手术方法。结论:在连续环形撕囊术中理解力的矢量和物理过程,这对于良好的操作和避免放射状撕裂是必要的。在连续环形撕囊术中应该要考虑到不同年龄和不同类型白内障的晶状体囊性质的改变会导致不同的撕裂角度和力度。

AIM： To determine the tearing angle and tearing force, and effects of associated pressures in tearing of various materials and human lens capsule in continuous curvilinear capsulorhexis （CCC）. METHODS： Tearing was done on different materials such as aluminum laminated paper, different types of thin transplant plastics and human lens capsule with blunt tip needle. During the procedure, angle and direction of force were measured. Effects of increased underlying pressure on tearing of tearable materials and effect of anterior chamber depth and vitreous pressure on 24 postmortem human eyes with different ages （range from10 to 75 years）, was evaluated. RESULTS： Tearing angle in every material was unique for that material. Angle and force of tearing was decreased reversely with increasing age （from 85 degree in a 10-years-old to 10 degree in older than 50 years）. Increasing vitreous pressure and decrease in AC depth causes higher pressure on point of tearing. Safe methods in controlling CCC are discussed in the context. CONCLUSION： Understanding the physics and vector of forces during CCC is necessary in good performance and avoidance of radial tears. Change in capsular properties between different ages and different type of cataract causes different tearing angle and tearing force that should be considered during CCC.