瞳孔环形后粘连的白内障超声乳化术

Phacoemulsification through pupillary circular posterior synechia.

目的 探讨瞳孔环形后粘连时的白内障超声乳化术的手术技巧。方法 对 30例 (32眼 )瞳孔环形后粘连的白内障患者采用钝性分离及非切开的牵拉法扩大瞳孔 ,进行原位超声乳化并人工晶状体囊袋内植入术。观察视力、瞳孔、术后并发症。结果 术后 1月矫正视力≥ 0 5者2 3眼 (72 7% ) ,术中 6眼采用机化膜剪除 ,非切开的牵拉扩大瞳孔法 ,4眼恢复圆形瞳孔 ,直径约 3mm ;2 6眼采用钝性分离后非切开的牵拉扩大瞳孔法 ,2 2眼恢复生理性圆瞳孔 ,直径约 2 5～ 3 0mm ,术后 6眼房水闪光(+)。结论 采用钝性分离及非切开的牵拉扩大瞳孔法 ,原位超声乳化可使瞳孔环形后粘连时的白内障恢复良好的视力和生理性圆瞳孔 。

Objective To investigate the surgical techniques in phacoemulsification through pupillary circular synechia.Methods The surgery was performed by using non cut pupil dilation and stable ultrasonic phacoemulsification and aspiration on 32 eyes of 30 patients with pupillary circular synechia.The visual acuity,pupil and postoperative complications were observed.Results One month after surgery,the corrected visual acuity was ≥0.5 in 23 eyes(72.7%).In 6 eyes,the procedure was performed after separation of synechia and excision of the organized membranes,a round pupil was obtained in 4 eyes,diameter 3 mm.26 eyes were emulsified using non cut pupil dilatation,22 eyes pupil were recovered to normal size (2.5～3 mm).6 eyes had aqueous flare (+).Conclusion After phacoemulisification through pupillary circular synechia by non cut pupillary dilatation,stable ultrasonic phacoemulsification and aspiration method,without any complications,the pupil can be recovered to normal and the corrected visual acuity after operation improved significantly.