伴有后囊缺陷的后极白内障的超声乳化手术

Phacoemulsification surgery in posterior polar cataract with posterior capsule defect

目的评价后极白内障的手术技巧和疗效。方法后极白内障31例（49只眼），总结术前术中后囊情况、手术低参数超声乳化技巧、术中并发症以及术后视力。结果术中后囊完整透明31只眼（63．26％），点状浑浊但保持完整10只眼（20．41％），术中后囊破裂8只眼（18．33％）。术后矫正视力：0．1—0．3者3只眼（6．12％），0．4-0．6者21只眼（42．86％），0．8～1．0者25只眼（51．02％）。结论后极白内障术中后囊破裂发生率比普通白内障高。通过特定的超乳仪器低参数设计、轻柔的水分层、黏弹剂辅助减少眼压大幅度变动等操作可以有效地减少术中并发症并提高术后视力。

Objective To analyse the surgical technique and post-operative visual outcome in eyes with posterior polar cataract. Methods Medical records of 49 eyes of 31 cases with posterior polar cataract were reviewed. The pre-and post-operative posterior capsule situation, technique of low parameter phacoe- mulsification surgery, intraoperative complications and visual outcome after surgery were summarized. Results The posterior capsule was intact and transparent in 31 eyes （63.26%） , intact with punetate opacity in 10 eyes （20.41%）, with posterior capsule rupture in 8 eyes （18.33%）. The post-operative BCVA （ best corrected visual acuity） were 0.1 -0.3 in 3 eyes （6.12%） , 0.4 -0.6 in 21 eyes （42.86%） , and 0.8 - 1.0 in 25 eyes （51.02% ）. Conclusion The incidence of posterior capsular rupture of posterior polar cataract surgery is higher than ordinary cataract surgery. With specific design of low parameters of phaeoemulsification instrument, gentle hydrodissection and reduction of large IOP （ intraoeular pressure） fluctuation with the assistance of viscoelastics, etc, the intraoperative complications can be effectively reduced and the visual outcome will be improved.