人工晶体植入术中后囊破损38例分析

ANALYSIS ON 38 CASES OF POSTERIOR CAPSULAR RUPTURE DURING IOL IMPLANTATION

目的对白内障囊外摘除人工晶体植入术中发生后囊破损的原因、特点、并发症等进行分析。方法对老年性白内障591眼按手术进程与后囊破损发生的关系进行记录。结果发生后囊破损40眼（6．8％），合并玻璃体脱出36眼（6．1％），后囊破损发生于娩核过程中13眼（32．5％），吸皮质过程中19眼（47．5％），其他8眼。总结后囊破损主要因素为：晶体核浮起不全；核大切口小，强行娩出；小瞳孔下反复吸取周边皮质撕拉囊膜；植晶体时后房压力高，用力下推下襻压破后囊等。结论充分了解后囊破损的易发因素，努力提高手术技巧，是防止后囊破损的重要环节；一旦发生，妥善处理，仍可获得良好视力。

Objective To analyse the reasons,features and complications of posteriorcapsular rupture(PCR) in extracapsular cataract extraction with introcular lens (IOL)implantation. Methods The PCR was recorded according to the stage of operative procedure in 591 eyes with senil cataract. Results There were 40 eyes (6. 8% ) with PCR and 36eyes (6. 1% ) of them accompanied with vitreous prolapse. The 13 eyes (32. 5% ) withPCR occurred during manual expression of the crystal nucleus, 19 eyes (47. 5% ) in thecourse of aspiration of the cortex and & eyes in the other stages. The main factors of PCRwere:the nucleus floated incompletely,smaller incision for the bigger nucleus forced thenucleus expression,smaller pupil in the course of nucleus expression tore capsular bagwhile repeatedly removing peripheral cortex, and higher pressure from the posteriorchamber pushed excessively the upper loop to break the posterior capsular. Conclusion Afull understanding of the main cause of PCR and improving operation skill plays an important part in preventing the PCR. If the PCR occurred,it should be handled appropriately,for a good vision may still be acquired.