分步环形撕囊术在小切口ECCE联合IOL植入术中的应用

Application of discontinuous (2-steps) circular capsulorhexis(DCC) in ECCE with IOL implantation in small incision technique

目的 探讨分步环形撕囊术 (discontinuous circular capsulorhexis,DCC)在小切口 ECCE联合 IOL植入术中的应用价值。方法 设计分步环形撕囊术 ,并应用于小切口 ECCE联合 IOL植入术中 36例 (36眼 )。观察术中囊袋口放射状撕裂 ,和由此引发的后囊膜破裂、玻璃体溢出发生率 ,并与信封式撕囊术 (envolop capsulorhexis,EC ) 30例 (30眼 )比较。结果 DCC组囊袋口放射状撕裂发生率 (10眼 ,占 2 7.8% )明显低于 EC组 (2 5眼 ,占83.3% ) (P <0 .0 1) ,后囊膜破裂 (3眼 ,占 8.3% )、玻璃体溢出 (2眼 ,占 5 .6 % )也明显低于 EC组 (9眼 ,占 30 %及 6眼 ,占 2 0 % ) (P <0 .0 1)。结论 小切口 ECCE联合 IOL植入术中采用 DCC技术囊袋口撕裂的机会显著减少 ,后囊膜的安全性明显增加。

Objective To study the effect of application of discontinuous (2-steps) circular capsulorhexis(DCC) in ECCE with IOL implantation in small incision technique Methods Discontinuous(2-steps) circular capsulorhexis(DCC) was designed and put into clinical use in ECCE with IOL implantation in small incision technique in 36 eyes.The prevealence of intraoperative radial tears of the anterior capsular openning,the posterior capsular tears and the loss of the vitreous body were observed and compared to the same small incision technique but with the envolope capsulorhexis in 30 eyes.Results The prevalence of the radial tears of the capsular openning in DCC group in 27.8% (10 eyes) was remarkably lower than that in EC group in 83.3% (25 eyes),(P<0.01);The tears of the posterior capsule in 8.3% (3 eyes),and the loss of the vitreous body in 5.6%(2 eyes) in DCC group were less than that in EC group with 30%(9eyes) and 20%(6 eyes) respectively (P<0.01).Conclusion The results show that the chance of tears of the anterior capsular openning decrease remarkably when DCC technique is applied in the ECCE with IOL implantation in small incision technique,and then the safty of the posterior capsule is clearly improved.