后囊连续环形撕囊术并发症分析

Analysis of the complications of posterior continuous circular capsulorhexis in catatact surgery

目的探讨后囊连续环形撕囊术手术操作及并发症的处理。方法对１３２只眼进行后囊连续环形撕囊术。用截囊针刺开后囊，注射粘弹剂至 Ｂｅｒｇｅｒ氏间隙，弧形剪开后囊使之翻转形成起始瓣，以撕囊镊撕除３ｍｍ大小之圆孔。术后随访５～２８个月。结果术中并发症有后囊环形撕囊完成困难，撕囊失控，囊袋不完整。术后并发症为人工晶状体后玻璃体疝，人工晶状体偏心及囊样黄斑水肿。随访时矫正视力 ０． ８以上者 ４５只眼，０． ４～０． ６者３２只眼，０．１～０． ３者４只眼。随访８１只眼显示周边后囊均有不同程度混浊，视轴区均透明。结论后囊连续环形撕囊术能保持视轴区透明，并发症的发生与术者的操作技术和经验密切相关，在开始进行后囊环形撕囊术时，应有选择性。

Objective To evaluate the manipulation and management of complications during posterior continuous circular capsulorhexis(PCCC) in cataract surgery. Methods PCCC was performed on 132 eyes before 10L implantation. The posterior capsule was punctured with a cystome. Viscoelastic was injected into the Berger's space. A capsular flap was created with a vannas scissors. The capsular flap was then torn around with a forceps to achieve a posterior capsular hole with a diameter of 3mm. The patients were followed up for 5-8 months. Results The complications during surgery were in accomplishing PCCC, uncontrolled PCCC and disrupted integrity of the capsular bag. The postoperative complications included vitreous prolapsing into the posterior chamber,eccentric 10L and cystoid macular edema. Corrected visual acuity was 0. 8 or better in 45 eyes,0.4-0.6 in 32 eyes and 0.1-0. 3 in 4 eyes during follow-up. Slit-lamp examination of the 81 eyes showed opacification of the peripheral posterior capsule with transparent visual axis area. Conclusion By PCCC the visual axis area remains transparent postoperatively. Incidence of the complications is related to surgical technique and experience of surgeons. At the beginning of performing PCCC,selection of cases is necessary.