针头抽吸方法在白色膨胀白内障撕囊术中的应用

Application of syringe needle suction method in white expansion cataract capsulorhexis

目的:探讨针头抽吸方法在白色膨胀白内障撕囊术中的临床疗效。方法:应用针头抽吸方法后连续环形撕囊(CCC)治疗白色膨胀白内障166眼。15°穿刺刀在3∶00位作辅助切口,注入带有灭菌空气的台盼蓝染色剂约0.1mL进行前囊膜染色,向前房内注入透明质酸钠,再用3.2mm穿刺刀作上方角膜缘切口,保持主切口偏小,然后用一个1mL带27G针头,斜面朝上,穿刺前囊膜抽吸液化皮质,斜面侧向旋转不扩大前部的穿刺口,轻轻压迫晶状体核,继续将前移的核后部的液化皮质吸走,用足够的黏弹剂填充前房,随后用3.2mm穿刺刀扩大角膜切口,完成CCC。结果:白色膨胀白内障166眼应用此方法,155眼成功完成了环形撕囊,成功率93.4%。结论:白色膨胀白内障超声乳化手术撕囊过程中,应用针头抽吸方法,通过吸走足够的液化皮质,清除部分膨胀晶状体,不但减轻了晶状体和囊袋的压力,从而可达到环形撕囊的目的,而且减少了因前囊膜不完整带来的手术操作不便和并发症,是一种安全、简便、有效的操作方法,便于掌握和应用。

AIM： To discuss clinical therapeutic effect of syringe needle suction method in treating white expansion cataract capsulorhexis. METHODS： Continuous circular capsulorhexis （CCC） treatment for white expansion cataract was adopted in 166 eyes by applying syringe needle suction method including using 15 stab knife as auxiliary incision at 3：00 place, injecting trypan blue stain with sterilized air about 0. l mL to staining anterior capsule, injecting sodium hyaluronate into anterior chamber, using a 3.2ram stab knife as above transparent corneal incision, keeping primary incision a bit smaller, using a lcc 27G syringe needle to puncture into anterior capsule with the slope upwards to suct the liquefied cortex, sloping lateral rotation without expanding the forward puncture incision, oppressing gently lens nucleus, continuing to suck up liquefied cortex which had moved forward, and filling in anterior chamber with enough sodium hyalurantae. And then after using a 3.2mm stab knife to expand corneal incision, CCC was finished. RESULTS： A total of 166 eyes with white expansion cataract applied this method. The circular capsulorhexiswere completed successfully in 155 eyes with a success rate of 93.4%. CONCLUSION = CCC treatment applying syringe needle suction method in white expansion cataract capsulorhexis can not only reduce the pressure of lens and capsular bag to realize the goal of posterior continuous curvilinear capsulorhexis, but also reduce the inconvenience of surgical operation brought by the incompleteness of capsule and complication. It is a safe, simple and effective operation method, which is easy to master and apply.