短眼轴性白内障手术的临床观察

Clinical observation of cataract operation in an eye with shorter axial length

目的:探讨短眼轴性白内障手术难度及术中、术后并发症的预防。方法:对57例63眼眼轴长度为20.26～22.11mm的白内障患者实施小切口非超声乳化白内障摘除术,对71例82眼眼轴长度为20.26～22.11mm的白内障患者实施超声乳化白内障吸除术,对比观察两种术式术后视力及并发症。结果:术后第1wk矫正视力≥0.5的术眼中小切口组占86%,超声乳化组占87%;术后3mo矫正视力≥0.5者均占94%,≥0.8者分别占49%和51%,两组相比无显著性差异。角膜水肿:小切口组为17%,超声乳化组为20%;后囊膜破裂:小切口组5%,超声乳化组5%;虹膜损伤:小切口组3%,超声乳化组1%。结论:短眼轴性白内障患者手术难度大,通过术前降低眼压,术中规范切口,合理使用黏弹剂,维持前房深度,对硬核选择合适的手术方式,患者可获得很好的复明效果。

AIM：To analyze the operative difficulty of cataract operation in an eye with shorter axial length and discuss its preventive measures of the complications.METHODS： To operate extracapsular extirpation cataract with minor incision for 57 cases （63 eyes）. To operate cataract phacoemulsification for 71 cases （82 eyes）. Their ocular axial lengths were 20.26 to 22.11mm. We observed the vision after operation and the complications of two groups in contrast.RESULTS： Among these patients, the minor incision group, whose vision exceeded 0.5 in the first postoperative week accounted for 86% and cataract phacoemulsification group 87%.The best corrected vision exceeding 0.5 after three months was 94% and 94%, among these patients, corrected vision exceeding 0.8 was 49% and 51%.There was no significant difference between the two groups （P〉0.05）. Corneal edema： there were 17% in minor incision group and 20% in cataract phacoemulsification group. Posterior capsular rupture： there were 5% in minor incision group and 5% in cataract phacoemulsification group. Iris injury： there were 3% in minor incision group and 1% in cataract phacoemulsification group.CONCLUSION： The cataract operation in an eye with shorter axial length is hard to perform. With the reduction of the intraocular pressure before operation, the correct technique of incision in the operation, the help of Viscoat viscoelastic material, the maintenance of deep anterior chamber and the convenient technique to hard nucleus, the patients can obtain satisfactory operative results