改良不缝合白内障囊外摘除术在健康快车硬核白内障疗效分析

Outcome of ameliorated sutureless incision extracapsular cataract extraction for hard nuclei on Lifeline Express

目的评价改良不缝合白内障囊外摘除术在健康快车硬核白内障疗效。方法选择2012年10～11月在福建省龙岩市健康快车光明行动中，72只眼（72例）IV级以上硬核白内障患眼，行改良不缝合白内障囊外摘除术，随访术后裸眼视力、眼压、手术并发症及术眼恢复过程等情况。结果术后第1天59只眼裸眼视力≥0．3，占全部术眼的81．94％；术后1周复诊，其中术后1天视力〈0．3的13只眼中11只眼裸眼视力≥0．3；术后第1天，6只眼眼压升高，经高渗剂及抑制房水生成药物治疗后好转，术后1周眼压较术前无明显改变；术中无后囊破裂及虹膜脱出发生，1只眼切口需要缝合；术后1周术眼角膜水肿及房水闪辉基本消失。结论在健康快车等短期大量白内障手术的复明行动中，改良不缝合白内障囊外摘除术适用于硬核白内障患者。该术式安全有效，术后早期即可获得满意的效果。

Objective To evaluate the outcome of ameliorated sutureless incision extracapsular cataract extraction for hard nuclei on Lifeline Express. Methods A total of 72 eyes from 72 cases of hard nuclei of age-related cataract on Lifeline Express in Longyan, Fujian Province were involved in this study, for which ameliorated sutureless incision extracapsular cataract extraction combined with intraocular lens implantation was pertbrmed. Visual acuity, intraocular pressure, complications and clinical signs were followed up for 1 day and 1 week post-operation and analyzed. Results On day 1 post operation, 59 eyes （81.94%） got uncorrected visual acuity （UCVA） better than 0.3. And 11 eyes got UCVA visual acuity better than 0.3 on day 7 post operation, which had UCVA worse than 0.3 on 1 day. Six eyes got higher intraocular pressure on day 1 post operation, which were controlled by 20% of mannital and other aqueous humor inhibitants in 2 to 3 days. No signifi- cant change was found for intraocular pressure between pre- and 1 week post operation. No posteri- or capsule rupture occurred and iris prolapsed during surgeries. Surgery-related corneal edema and an- terior chamber flares disappeared in the following week. Conclusions Ameliorated sutureless inci- sion extracapsular cataract extraction is safe and effective for hard nuclei cataract victims during short-term, large-volume Vision Action.