改良小切口劈核技术在硬核性白内障手术中的应用

Application of Modified Nuclear Manual-chop Technique in Small Incision Hard Cataract Surgery

【目的】探讨改良巩膜隧道小切口劈核技术在硬核性白内障非超声乳化手术中的意义。【方法】112例(121眼)Ⅳ～Ⅴ级硬核性白内障采取改良手法劈核行巩膜隧道小切口非超声乳化摘除人工晶体植入手术,回顾性分析了手术中劈核情况、术后视力及手术并发症。【结果】105眼一次劈核成功,16眼劈核后底部未完全分离但出核时分成两瓣顺利娩出。术后两周视力大于0.3者98眼,大于0.1者113眼,术后轻度角膜水肿25眼,中度角膜水肿13眼。【结论】硬核性白内障小切口非超声乳化手术中应将硬核分成两部分,使直径变小后再娩出,改良手法劈核无需特殊器械、操作简便、安全实用。

[Objective] To evaluate the application of nuclear manual-chop technique modified with small incision in nonphacoemulsification of hard cataract. [Methods] It was performed in ll2 cases （121 eyes） of age-related cataract with nucleus in grade IV-V in non-phacoemulsification nuclear manual-chop through scleral turnel incision. A retrospective study was carried in the condition of splitting core, post-operative visual acuity and complications. [ Results ] The nuclei of 105 patients were successfully divided into two sections with nuclear manual-chop technique at one time, in the other 16 eyes, the bottom of the nuclei was not totally isolated at one time, but it was completed when the nucleus were extracted. The post-operative visual acuity of 98 eyes was over 0.3 and 113 eyes over 0.1 two weeks later. Mild post-operative corneal edema happened in 25 eyes and moderate postoperative corneal edema in 13 eyes. [Conclusions] Nuclear manual-chop with small incision in non-phacoemulsification of hard cataract can successfully divided the nuclei into two sections which can be extracted more easily, Manual-chop technique modified could be performed without special instrument. It is quick, safe and effective.