小切口“V”型截囊白内障术中晶状体后囊膜破裂的原因分析及处理

Posterior Lens Capsule Rupture in Small Incision "V" Type Capsulotomy in Cataract Surgery

目的探讨小切口"V"型截囊白内障囊外摘除术中晶状体后囊膜破裂的原因及处理。方法对武宁县人民医院2009年"光明工程"893例(925眼)白内障囊外摘除术中的63例(6.81%)晶状体后囊破裂患者的临床资料进行回顾性分析,并根据晶状体后囊膜破裂的发生时间进行原因分析及处理。结果 63眼后囊膜破裂患者中水分离时9眼、吸皮质时46眼、娩核时5眼、人工晶体植入时2眼、撕除三角形前囊膜瓣时1眼;一期植入后房型人工晶体57眼,6眼因眼底无红光反射未植入人工晶体。出院时视力情况:视力>0.4者57眼,视力<0.1者6眼。结论白内障囊外摘除术晶状体后囊膜破裂是常见的并发症,可发生在术中诸多手术步骤中。规范手术操作可降低其发生率,恰当的处理,可避免并发症的发生,并可获得较好的术后视力。

Objective To analyze and treat posterior capsule rupture in small incision ＂V＂ type capsulotomy in extracapsular cataract extraction surgery.Methods Clinical data of 63 cases of posterior capsule rupture（6.81%） of 893 patients（925 eyes） undergoing extracapsular cataract extraction surgery in Wuning county people＇s hospital were analyzed.Results Of the 63 eyes,posterior capsule rupture occurred during hydrodissection in 9 eyes,during cortical aspiration in 46 eyes,during nucleus delivery in 5 eyes,during intraocular lens implantation in 2 eyes,and during tearing anterior capsule flap in 1 eye.Fifty-seven eyes received posterior chamber intraocular lens implantation,and 6 eyes were not implanted intraocular lens due to loss of red fundus reflex.Postoperative visual acuity at discharge was greater than 0.4 in 57 eyes and less than 0.1 in 6 eyes.Conclusion Posterior capsule rupture is a common complication during extracapsular cataract extraction surgery and may occur during many surgical procedures.Standardized surgical procedures and proper treatment can reduce the incidence of posterior capsule rupture to attain a better postoperative visual acuity.