白内障超声乳化术中切口下皮质的处理

Subincisional cortex removing in cataract phacoemulsification

目的寻找一种安全、简便的完全清除白内障超声乳化术中切口下皮质的方法。方法在本科白内障超声乳化术中用常规I/A直头注吸皮质,切口下皮质清除不完全的47例,按手术奇偶数顺序改用带角度的超声乳化注吸头注吸24例,用自制钝弯针头干吸23例,观察皮质清出效果。结果 23例用钝弯针头干吸患者皮质全部清除干净。用带角度超声乳化注吸头组中3例患者切口下残余皮质注吸干净,其余21例改用钝弯针头干吸,皮质清除干净。钝弯针头干吸均在2min内完成,2例囊袋裂开,1例后囊膜破裂,均一期植入人工晶状体。结论白内障超声乳化手术中切口下皮质的处理,带角度的注吸头与直头相比无明显优势,用钝弯针头干吸效果明显、安全,可以作为有益补充。

Objective To explore a safe and convenient method to completely remove subincisional cortex in cata- ract phaeoemulsification. Methods Forty-seven cases who were not thoroughly removed cortex using straight I/A han- dle in cataract phacoemulsification were concluded in the study. Angled I/A handle was used to remove subincisional cortex in 24 cases and self-made blunt needle in 23 cases. Methods were chosen based on an odd even order. The re- moving effect was observed in all cases. Results In the blunt angled needles＇ group, cortex was entirely removed, while the same effect was achieved in only 3 cases in the angled I/A handle＇s group. The remaining 21 cases were trea- ted using blunt angled needles to remove the cortex thoroughly. The average time of cortex remove by using blunt angled needle was less than 2 min. There were two cases of capsule dehiscence and one case of posterior capsule rupture. The both patients were treated with intraocular lens implantation. Conclusions In cataract phacoemulsifieation, there was no notable advantage of using the angled I/A handle compared with the straight one. Self-made blunt needle was a safe and effective tool in cortex removing and could be a beneficial supplement.