低参数超声乳化治疗晶状体半脱位白内障患者临床观察

Clinical efficiency of slow motion phacoemulsification in treatment of patients with cataract and lens subluxation

目的探讨低参数白内障超声乳化吸出术治疗晶状体半脱位白内障患者的安全性及临床效果。方法分析2010年3月至2011年6月我院行白内障超声乳化吸出术的晶状体半脱位白内障患者10例(10眼),采用Alcon公司Infiniti超声乳化仪行白内障超声乳化摘出半脱位的晶状体,术中采用低参数设置(低流量、低负压、低灌注、低能量),摘出晶状体后植入囊袋张力环及后房型人工晶状体。观察患者术后的视力、眼压、角膜内皮细胞计数及并发症情况。结果术后患者未矫正远视力及最佳矫正远视力较治疗前均有不同程度提高。患者术前与术后眼压无明显差异,患者术后角膜内皮细胞计数较治疗前有所减少,但术后角膜内皮细胞丢失率低,术后6个月为(9.91±3.19)%。人工晶状体位置居中性好,无明显严重并发症发生。结论低参数超声乳化手术治疗晶状体半脱位的白内障,视力提高显著,并发症少,是一种安全、有效手术治疗方法。

Objective To observe the safety and clinical effects of slow motion phacoemulsification in the treatment of patients with cataract and lens subluxation.Methods Ten cataract patients with lens subluxation,whom underwent the combination slow motion phacoemulsification surgery and posterior chamber intraocular lens（IOL） implantation from March 2010 to June 2011,were recruited in clinical study.Semiluxation cataract was taken out with phacoemulsification by Infiniti ultrasound instrument（Alcon Company）.In the surgery,low parameter set was taken as low flow,low negative pressure,low perfusion and low energy）.And then capsular ring and posterior chamber IOL was implanted.The changes of vision,intraocular pressure,corneal endothelial cells count and complications were observed after therapy.Results The uncorrected distance visual acuity and best corrected distance visual acuity were improved at different degrees after surgery compared with those of before therapy.There was no statistical difference in intraocular pressure before and after surgery,the corneal endothelial cells count after surgery was less than that before surgery.The loss rate of corneal endothelium was low as（9.91±3.19）% at 6 months after surgery,the IOL of all patients have a good position and there were no obvious complication after therapy.Conclusions The slow parameter phacoemulsification surgery is an accurate method in the treatment of cataract with lens subluxation.It is an effective and safety therapy to lighten the response of anterior chamber,and remission of complication and improve the vision at different degrees.