挤压劈核在过熟期白内障超声乳化吸除术中的应用

Application of lift and squeeze technique in phacoemulsification of hypermature cataract

目的：评价挤压劈核技术在过熟期白内障超声乳化手术中应用的有效性和安全性。 方法：收录2010-06/2013-06于我院行超声乳化摘除术的过熟期白内障156眼,术中采用挤压劈核技术,1g/L台盼蓝辅助撕囊。观察术中超声乳化时间、并发症、术后角膜水肿及视力恢复情况。 结果：术后3mo,最佳矫正视力0.1~0.4者15眼（9.6%）,0.5~0.7者82眼（52.6%）,0.8~1.0者59眼（37.8%）。超声乳化时间25~56（平均42＆#177;10）s,最大超声乳化能量30%。术中后囊膜破裂玻璃体脱出2眼（1.3%）,IOL植入睫状沟。术后角膜水肿Ⅰ级者12眼（7.7%）、Ⅱ级者5眼（3.2%）,Ⅲ级及Ⅳ级者0眼。术后3mo平均角膜内皮丢失率为8.7%。 结论：台盼蓝囊膜染色技术增加了连续环形撕囊的成功率；挤压劈核减少了对悬韧带和晶状体囊膜的牵拉,缩短了超声乳化时间,减少了能量的应用。

AIM： To evaluate the effectiveness and security of lift and squeeze technique in phacoemulsification of hypermature cataract. METHODS： From June 2010 to June 2013, totally 156 eyes with hypermature cataract, which received phacoemulsification in our hospital, were enrolled. Lift and squeeze technique was used to chop the nucleus, and lg/L Trypan blue was used for capsulorhexis. Average time of phaco complication, corneal edema and visual outcome were recorded. RESULTS： The best-corrected visual acuity （BCVA） was 0.1-0.4 in 15 eyes （9.6%）, 0.5-0.7 in 82 （52.6%） eyes, and 0. 8-1. 0 in 59（37. 8%） eyes at 3mo after surgery. The phaco time was 25-56s （average 42±10s）, the maximum phaco power was 30%. Posterior capsular rupture and vitreous loss happened in 2 eyes （1.3%）, and the IOLs were implanted in the sulcus. Corneal edema classified at grade Ⅰ were seen in 12 eyes （7.7%）, and 5 eyes （3.2%） at grade Ⅱ, no eye at grade Ⅲ and grade Ⅳ. The mean endothelial cell loss was 8.7% at 3mo. CONCLUSION： Crystalline lens capsule staining with Trypan blue increase the success rate of intact continuous curvilinear capsulorhexis （CCC）. The lift and squeeze technique reduces the stress on the zonules and capsule, and decreases the phaco time and phaco power.