1.4mm微切口白内障超声乳化术临床探讨

The Clinical Discussion of 1.4mm Micro-incision in Phacoemulsification

目的:探讨微切口白内障超声乳化术的手术技巧及疗效。方法:选择100眼II-IV级核单纯性老年性白内障,随机分为两组:传统超乳组50眼,行2.8mm切口常规超乳术;冷超乳组50眼,行1.4mm切口超乳术;探讨两组手术技巧、所需能量、时间、前房稳定状况,观察术后效果。结果:100眼均成功乳化吸除白内障,并植入人工晶状体。传统超乳组前房更稳定,所需能量更小(30%-50%),平均超乳时间更短(22秒),但术后反应较重,术后1天、1周、1月视力≥0.5者占42%、78%、94%;冷超乳组所需能量要大20%(50%-70%),平均超乳时间长些(33秒),术中前房变浅3眼,后囊损伤2眼,术后1天、1周、1月视力≥0.5者占52%、84%、94%。结论:术后1天、1周视力,1.4mm切口优于2.8mm切口白内障超乳术,1月后二者无差异,但是,冷超声乳化技术、手术技巧、适用于微切口的人工晶状体等方面还有待完善。

Objective：To investigate the surgical techniques and the effect of micro-incision in Phacoemulsification. Methods： Onehundred selected Ⅱ-Ⅳ grade nucleus simple senile cataract eyes were divided into two random groups. Fifty eyes grouped under tradi - tional phacoemnlsification were operated on by 2. 8mm-incision phacoemulsification. Fifty eyes grouped under cold phacoemulsification were operated by 1.4mm-incision phacoemulsification. The surgical techniques,the energy required,time required,stable status, and the effects after operations in each group were then investigated Results： All 100 eyes were emulsifieated and exhausted successfully. Inter-ocular lenses （IOL） were implanted. The anterior chamber in the group of traditional phacoemulsification was more stable, the energy required was less（30% -50% ） ,the average time required in phacoemulsification was shorter（22s） ,but the reaction after opera- tion was more serious. The patients whose vision ≥ 0. 5 occupied 42% ,78% ,and 94% in one day after the operation,one week after operation, and one month after operation respectifully. The energy require in the group of cold phaeoemulsification was 20% more （50% -70% ） ,and the average time required in phacoemulsification was a bit longer（33s）. The anterior chambers in three eyes diminished after the operation. The posteriors of two eyes were injured. The patients whose vision was ≥ 0.5 occupied 52% , 84% , and 94% in one day after operation, one week after operation, and one month after operation, respectfully. Conclusions： The vision after the operations of a 1.4ram micro-incision phacoemulsification is better than that of a 2. 8ram incision phacoemulsification in one day and one week after surgery. There is no difference after one month between the two, but there are still somethings which should be improved such as the technique of cold phacoemulsification,surgical technique,the IOL which is suitable for micro-incision etc.