圈垫式劈核在小切口白内障手术中的应用

Application of chop technique with lens loop-pad in small incision cataract surgery

目的:评价圈垫式劈核在小切口白内障囊外摘除术中的应用。方法:对79眼白内障应用圈垫器和切核刀进行劈核取出,植入后房型人工晶体。观察术中、术后的并发症及术后视力。结果:78眼患者一期囊袋内植入人工晶体,3例眼术中后囊破裂,其中2眼后囊破口小,人工晶体仍植入囊袋内,1眼因后囊破口大,人工晶体于睫状沟植入。术后第1天角膜轻度水肿17眼,占21.5%;中度水肿1眼,占1.3%;一过性高眼压4眼,占5.1%。术后2周视力0.1～0.25者3眼,占3.8%;0.3～1.0者76眼,占96.2%。结论:圈垫式劈核在小切口白内障囊外摘除术中的应用是安全、简便的,且手术成本低,适合在基层医院和大规模白内障复明行动中开展。

Objective：To evaluate the application of chop technique with lens loop-pad in small incision cataract surgery.Methods： Seventy-nine cataract lens were removed with loop-pad and chop knife before implanting posterior chamber intraocular lens,with observation of the intra-and postoperative complications and visual acuity correction after the procedure.Results： Intraocular lens（IOL） were primarily implanted in capsular bag of 78 eyes.Intraoperative posterior capsule rupture occurred in 3 eyes,in which implantation was successful in 2 eyes owing to posterior capsular smaller laceration and 1 was managed via ciliary sulcus due to larger laceration.Mild cornea edema was seen in the first postoperative day in 17 eyes（21.5%） and moderate edema in 1 eye（1.3%）,transient high intraocular pressure in 4 eyes（5.1%）.Visual acuity was corrected after 2 weeks by 0.1-0.25 in 3 eyes（3.8%） and 0.3-1.0 in 76 eyes（96.2%）.Conclusion：Chop technique with lens loop-pad in small incision cataract surgery can be recommended to community-based hospitals and large scale cataract operation for its safety,simple performance and low cost.