白内障超声乳化术后囊膜破裂的临床分析

The clinical analysis of posterior capsule rapture during phacoemulsification

目的:探讨白内障超声乳化手术中后囊膜破裂发生的原因、处理方法及对视力的影响。方法:将白内障超声乳化手术中发生后囊膜破裂17例分为2组:A组11例,在超声乳化核块过程中发生后囊膜破裂;B组6例,在注吸皮质和植入人工晶体时发生后囊膜破裂。比较2组术后视力、眼压、瞳孔、人工晶体位置、眼底情况。结果:术后1周,A组角膜水肿、前房反应和玻璃体混浊与B组差异均无统计学意义(P>0.05),A组视力低于B组(P<0.01)。术后3个月,A组最佳矫正视力、瞳孔欠圆和眼底黄斑水肿发生率与B组差异均无统计学意义(P>0.05),但2组术后视力均明显好于术前。结论:白内障超声乳化术中发生后囊膜破裂,只要术中及时发现、正确处理,不会产生其他严重并发症,仍可以提高患者的视力,提高超声乳化手术初学者的信心。

Objective：To investigate the reason,treatment of posterior capsule rapture during phacoemulsification and effects on the vision.Methods：The data of 17 cases with posterior capsule rapture during phacoemulsification were retrospectively analyzed.All cases were divided into group A （11 cases） and group B （6 cases）.The posterior capsule rapture of group A and group B occurred during the phacoemulsification,and injection and suction of cortex and intraocular lens implantation,respectively.The visual acuity,intraocular pressure,pupil,location of artificial crystal and fundus between two groups were compared.Results：The differences of corneal edema,anterior chamber reaction and vitreous opacity between two groups were not statistically significant in 1 weeks after operation （P ＞ 0.05）.The vision acuity in group A was lower than that in group B （P ＜ 0.01）.The differences of best corrected visual acuity,non-round pupil and incidence of fundus macular edema between two groups were not statistically significant in 3 months after operation （P ＞ 0.05）.Compared with before operation,the visual acuity of two groups were improved significantly after operation.Conclusions：The timely discovery and treatment of posterior capsule rapture during phacoemulsification can reduce the serious complications,improve the patient＇s vision and strengthen the confidence of the emulsification beginner.