首创小切口白内障手术中黏弹剂辅助脱核方法

Application of viscoelastic materials aided nucleus extraction in small-incision cataract surgery

目的介绍首创黏弹剂辅助脱核方法的操作过程。方法 回顾分析年龄相关性白内障患者260例(298眼)在连续环形撕囊下应用黏弹剂辅助脱核方法脱核,施行手法无缝线小切口白内障手术,对其术后视力及其他临床资料进行分析。结果 术后患者视力均有不同程度的提高。术后3d最佳视力≥0.05者296眼,复明率99.33%;视力≥0.3者277眼,脱残率占92.95%。术后30d最佳矫正视力≥0.05者296眼,复明率99.33%,≥0.3者282眼,脱残率占94.63%。术后90d最佳矫正视力≥0.05者295眼,复明率98.99%,≥0.3者280眼,脱残率占93.96%。术中和术后出现不同程度的并发症,角膜内皮线性混浊伴角膜雾状混浊和前房水混浊21眼,虹膜炎2眼,后囊膜混浊1眼,经对症处理后均得到好转和治愈,未见大泡性角膜炎、眼内炎等严重并发症发生。结论 黏弹剂辅助脱核方法在手法无缝线小切口白内障手术中是一种简单、实用、快捷、经济、术后效果好的新方法。

Objective To introduce the application of viscoelastic materials aid during nucleus extraction in manual sutureless small-incision cataract surgery.Methods About 260 age-related cataract patients（298 eyes）were retrospectively analyzed,and they were taken continuous circular capsulorhexis,manual sutureless small-incision cataract surgery with viscoelastic needle to assist nucleus extraction.Postoperative visual acuity and clinical data were analyzed.Results All cases had vision improvement postoperatively.At postoperative 3 days,best corrected visual acuity be and more than 0.5 was in 296 eyes,and the rate of requiring sight was 99.33%;Visual acuity be and more than 0.3 was in 277 eyes,and the rate of getting ride of disability was 92.95%.At postoperative 30 days,best corrected visual acuity be and more than 0.05 was in 296 eyes,and the rate of requiring sight was 99.33%;Visual acuity be and more than 0.3 was in 282 eyes,the rate of getting ride of disability was 94.63%.At postoperative 90 days,best corrected visual acuity be and more than 0.05 was in 295 eyes,and the rate of requiring sight was 98.99%;Visual acuity be and more than 0.3 was in 280 eyes,the rate of getting ride of disability was 93.96%.Various degrees of intra-operative and postoperative complications were found.There were 21 eyes with linear clouding of corneal epithelium with corneal fog clouding and anterior chamber clouding,2 eyes with iritis and 1 eye with posterior capsular opacity.All symptoms were improved or cured;There was no serious complication as bullous keratitis or entophthalmia.Conclusion Application of viscoelastic needle to aid nucleus extraction in manual sutureless small-incision cataract surgery is a new method,which is simple,practical,fast and economical,and has good curative effect.