超声乳化联合手法娩核术治疗硬核白内障的疗效观察

Curative effect of phacoemulsification united techniques on hard core cataract

目的探讨超声乳化联合手法娩核术治疗硬核白内障的临床效果。方法对78例高龄Ⅳ级以上硬核老年性白内障行白内障超声乳化联合手法娩核术并植入折叠式或硬性人工晶状体。结果78例(78眼)患者Ⅳ-Ⅴ级硬核超声乳化时间为0.3～0.8 min,平均0.5 min。切口无热损伤,无严重手术并发症发生,全部病例均顺利一期囊袋内植入人工晶状体。术后1周视力≥0.5者58眼。术后1个月视力≥0.5者68眼,其中≥1.0者16眼;0.1～0.5者4眼;≤0.1者6眼。术中后囊破损1眼,发现较早,及时处理后顺利完成一期囊袋内人工晶状体植入术。术后角膜不同程度水肿6眼,经结膜下注射地塞米松后,2～5 d水肿全部消失。后囊混浊导致视力下降1眼,经激光治疗后视力提高。随访期间所有患者均未发现角膜内皮失代偿。结论超声乳化联合手法娩核术治疗高龄硬核老年性白内障术后视力恢复快、效果好,手术迅速、安全、并发症少。

Objective To investigate the curative effect of phacoemulsification united techniques on hard core cataract. Methods Seventy-eight elderly cataract patients with hard core in Grade Ⅳ - Ⅴ were treated with phacoemulsiflcation combined with intraocalar lens implantation. Results The time of phacoemulsiflcation was 0.3 to 0. 8 minutes,average 0. 5 minutes. There was no heat injury in the cut and no severe operation complication. Intraoctdar lens were successfully implanted into sac at once in all cases. The visual acttity （VA） of 58 eyes was higher than 0.5 at 1 week after operation. At 1 month after operation, the VA of 68 eyes was higher than 0.5,16 eyes higher than 1.0,4 eyes between 0. 1 to 0.5,and 6 eyes less than 0. 1. One eye happened with backsack fracture, treated promptly,and implemented intraocular lens implantation in sac successfully; Cornea edema with different degrees was in 6 eyes. After treated with subconjunctival injection of hexadecadrol, edema completely disappeared at 2 to 5 days. VA of 1 eye lowered for backsack opacity, but improved after treated with laser, and no case happened with corneal endothelium decompensation. Conclusion Phacoemulsiflcation united techniques is a safe and effective method to treat elderly hard core cataract patients with well VA recovery and few complications.