粘连性小瞳孔白内障行晶状体超声乳化术的研究

A study of phacoemulsification for adhesive small pupil cataract

目的探讨粘连性小瞳孔下白内障的晶状体超声乳化的手术方法。方法对186例(227眼)小瞳孔白内障施行晶状体超声乳化术中先以人工晶状体分离虹膜前后粘连,应用黏障剂及人工晶状体调位钩或用虹膜拉钩开大瞳孔,或以晶状体囊剪开大瞳孔以完成超声乳化联合人工晶状体植入手术。结果全部227眼均顺利完成撕囊及超声乳化吸出术。后囊破裂者6眼(2.64%)。术后角膜不同程度水肿者61眼(26.8%)均于5～7d内消失。8眼未植入人工晶状体(3.52%)。结论利用黏弹剂及调位钩或晶状体囊剪扩大瞳孔是简单而有效的方法,不损伤或少损伤瞳孔括约肌,术后基本上能保持圆形或椭圆形瞳孔,减少术中、术后并发症。

Objective To discuss phacoemulsification on cataract with small adhesive pupil Methods 186 cases （227 eyes） of cataract with small adhesive pupil had undergone phacoemulsification. Firstly the anterior and posterior synechia were separated by viscoelastic agent and IOL adjusting hook or iris hook. Or the pupil was enlarged by capsule scissors. Results Capsulectomy and phacoemulsification had been finished in all the 227 eyes. Posterior capsule rupture occurred in 6 eyes （2.64%）. Postoperative cornea edema in 61 eyes （26.8%） disappeared in 5 -7 days. IOL was not implanted in 8 eyes （3.52%）. Conclusion It was effective and simple for enlargement of pupil by viscoelastic agent and hooks. The postoperative pupil could keep round because the sphincter muscle were not injuried.