硬核白内障小切口囊外摘出手术的体会

Experience on hard cataract small incision ECCE surgery

目的探讨小切口白内障囊外摘出人工晶状体植入术治疗硬核白内障的临床效果及手术技巧。方法我院完成2008年及2009年度市级白内障复明项目1038例(1038眼),均为小切口白内障囊外摘出人工晶状体植入术。回顾性分析其中278例(278眼)Ⅳ级以上硬核白内障手术的效果及术中、术后主要并发症。结果接受白内障复明项目手术者中硬核278例(278眼),占26.78%(278/1038)。主要手术并发症:后囊破裂6眼,占2.16%,术后1d角膜水肿52眼,占18.70%。术后一周视力≥0.05者275眼,脱盲率为98.92%;视力≥0.3者249眼,脱残率89.57%。术后虹膜炎症反应10眼占3.60%,暂时性高眼压9眼占3.24%,后囊浑浊13眼占4.68%。结论防盲复明项目中,硬核白内障的手术比例较高,难度较常规白内障手术大。小切口囊外摘出联合人工晶状体植入术对硬核白内障效果好,术中组织损伤小,术后反应轻,创口愈合快,而且不需特殊设备,操作相对简捷,易于掌握,似乎是适合于IV级以上硬核白内障的较理想的术式。

Objective To explore the small incision extracapsular cataract extraction and intraocular lens implantation in theclinical effect of hard nucleus cataract and surgical techniques. Methods From 2008 and 2009 to com alete the municipal hospital project 1038 cases of cataract （ 1038） are small-incision extracapsular cataract extraction and intraocular lens implantation,retro- spective analysis of which 278 cases （278） Ⅳ level and above hard the effects of nuclear cataract surgery and major postoperative complications. Results The Prevention of Blindness projects receiving a total of 1038 cases of surgery （1038） ,in which hard core of 278 cases （278） ,accounting for 26. 78% . Major complications： posterior capsule rupture in 6 eyes,accounting for 2. 16% ,After 1 days corneal edema in 52 eyes,accounting for 18. 70% . After 1 week visual acuity≥0. 05 in 275 eyes,literacy rate was 98. 92% ; vision of≥0. 3 249 eyes,removing residual rate of 89. 57% ,The iris in- flammation after surgery in 10 eyes （3. 60% ） ,transient high in- traocular pressure 9 eyes （ 3. 24% ） ,posterior capsular opacification accounted for 13 （4. 68% ） . Conclusion The prevention of blindness Fuming projects,hard-higher proportion of nuclear cataract surgery,cataract surgery is more difficult than conventional large. Small incision cataract extraction and intraocular lens im- plantation on the hard nuclear cataract effect,intraoperative tissue damage,mild postoperative reaction,wound healing,and no special equipment,the operation is relatively simple and easy to grasp,is suitable for IV and above the hard nuclear cataract surgical better.