白内障二次环形撕囊术

Two step method of continuous circular capsulorhexis in mature intumescent cataract.

目的 探讨白内障超声乳化吸出术新的撕囊术的临床意义。方法 在 315例肿胀白内障的超声乳化吸出术中 ,采用二次连续环形撕囊术 ,即先行约 4mm的连续环形撕囊 ,在人工晶状体囊袋内植入后再次连续环形撕囊 ,将前囊开口扩大至人工晶状体边缘。术后 2周～ 1年检查眼底并进行相应处理。结果 全部病例在术中未发生前囊开口放射状撕裂。术后检眼镜及荧光素眼底血管造影检查发现 74例眼底疾病患者 ,其中 13例接受视网膜激光光凝术治疗。残留的少量前囊对眼底检查和治疗过程影响甚小。结论 在白内障超声乳化吸出术中 ,对膨胀的白内障采用二次连续环形撕囊 ,不但有利于保持晶状体囊袋的完整性和囊口的中心性 。

Objective To evaluate the clinical significance of two-step method of continuous circular capsulorhexis in mature intumescent cataract.Methods Small (4 mm in diameter)continuous circular capsulorhexis(CCC) were performed in 315 cases of mature intumescent cataract and after endolenticular phacoemulsification and safe lens implantation,the window of anterior capsule was then enlarged by the second continuous circular capsulorhexis(2-CCC) according to the optic size of intraocular lens(IOL).2 weeks to 12 months later the fundus examination were performed in all surgical eyes.Results Successful CCC and 2-CCC were achieved in all cases.74 cases were diagnosed to have ocular fundus diseases through fundus examniation by indirect ophthalmoscope and fundus fluorescein angiography.13 of them received retinal photocoagulation therapy.And the opaque area caused by adhesion of peripheral anterior and posterior capsule will not disturb the fundus examination and treatment.Conclusion 2-CCC in phacoemulsification of mature intumescent cataract will not only preserve the shape of capsule,but also facilitate the diagnosis and treatment of fundus diseases in cataract patients.