非染色连续环形撕囊在白色白内障超声乳化中的应用观察

Observation on application of non-staining continuous circular capsulorhexis for white cataract ultrasonic phacoemul-sification

目的:探讨非染色连续环形撕囊超声乳化联合人工晶状体植入术治疗白色白内障的疗效。方法:对458眼白色白内障施行非染色连续环形撕囊超声乳化联合人工晶状体植入术,观察其撕囊成功率、术中的并发症、术后视力、术后角膜水肿反应等指标。结果:患者458眼中撕囊成功441眼(96.3%),17眼(3.7%)囊膜出现放射状撕裂,以剪刀剪出一囊膜瓣再完成撕囊。术中后囊膜破裂9眼(2.0%),术后轻度角膜水肿94眼(20.5%),中度水肿29眼(6.3%),重度水肿8眼(1.7%),水肿均在2～10d内消退,无角膜内皮失代偿。术后第1d视力均有明显的提高,视力>0.3者329眼(71.8%),术后1wk视力>0.5者417眼(91.0%)。结论:非染色连续环形撕囊超声乳化联合人工晶状体植入术治疗白色白内障虽手术操作较为困难,但熟练后成功率较高,术后视力恢复良好。

AIM： To investigate the non- staining continuous curvilinear capsulorhexis and phacoemulsification with intraocular lens implantation for the treatment of white cataract. METHODS： Totally 458 eyes with white cataract underwent phacoemulsification combined intraocular lens implantation, the success rate, intraoperative complications, postoperative visual acuity, corneal edema response index were observed. RESULTS： Of the 458 eyes, capsulorhexis was successful in 441 eyes （96.3%）, 17 eyes （3.7%） film radial tear occurred with scissors, capsular flap was cut out and capsulorhexis was completed. Intraoperative rupture of posterior capsule in 9 eyes （2. 0%）, mild postoperative corneal edema in 94 eyes （20. 5%）, moderate oedema block 29 eyes （6.3%）, severe edema in 8 eyes （1.7%）, both in 2 to 10 days without edema, corneal endothelial decompensation. After postoperative first day, visual acuity improved in 329 eyes（71.8% ） with visual acuity 〉0.3, postoperative one week visual acuity 〉0.5 in 417 eyes （91.0%）. CONCLUSION. Although non - staining continuous curvilinear capsulorhexis and phacoemulsification with intraocular lens implantation is difficult in treatment of white cataract, but after skilled operation, high success rate and good postoperative visual acuity can be obtained.