双手法旋转挤切晶状体核在硬核白内障小切口摘除术中的应用

The clinical application of rotating and chopping nucleus with two-handed technique in small-incision nonphacoemulsification hard nucleus cataract surgery

目的观察硬核白内障小切口摘除术中应用双手法旋转挤切晶状体核的临床疗效。方法27例(30只眼)Ⅳ级核以上老年性白内障病例行小切口白内障囊外摘除术,术中应用双手法旋转晶状体核进入前房,双手器械分别置于晶状体核上下,对冲挤切晶状体核为两半或多半,自闭巩膜隧道小切口拖出晶状体核,吸除皮质,囊袋内植入人工晶状体;并与同期行超声乳化术的30例(35只眼)硬核白内障病例观察对比。结果术后3个月最佳矫正视力:小切口组0.3～0.5者28只眼(93.33%),0.5～1.0者27只眼(90.00%);超声乳化组0.3～0.5者33只眼(94.29%),0.5～1.0者32只眼(91.43%),差异无显著意义(P>0.05);术中无后囊破裂及悬韧带离断发生,随访半年至1年,无视网膜脱离及黄斑囊样水肿发生。结论小切口白内障摘除术中应用双手法旋转挤切晶状体核具有操作简单、容易掌握,针对性及目的性强,手术效率高,临床效果佳,并发症少等特点,值得临床应用,特别适宜基层医院开展非超声乳化小切口白内障复明手术。

Objective To observe the clinical effect of rotating and chopping nucleus with two-handed technique in small-incision nonphacoemulsification hard nucleus cataract surgery. Methods 27 cases （ 30 eyes） of hard nucleus cataract received this kind of surgical treatmnet , the nuclear was rotated to the anterior chamber with two-handed technique, The nuclear was chopped into two pieces with the lens loop under the nucleus and lens hook on the nuclear and taken out; 30 eases （ 35 eyes） were performed phacoemulsificafion, the clinical outcomes were obtained and compared. Results Group of the small-incision nonphacoemulsification and phacoemulsification： Of the 28 （ 93.33% ） and 33 （ 94.29% ） eyes, the visual acuity was 0.3 ～ 0.5 ; Of the 27 （ 90.00% ） and 32 （ 91.43 % ） eyes, the visual acuity was 0.5 - 1.0; there were no significant difference （ P 〉 0.05 ） between these two groups, No complication which affected visual acuity was observed. Conclusion This kind of surgical treatment-rotating and chopping nucleus with two-handed technique in small-incision nonphaeoemulsification hard nucleus cataract surgery is safe , convenient and easy for extensive basic hospital, has the advantages of easy to be grasped, and a good dinical effct.