白色白内障高流量高负压爆破模式超声乳化术

Blasting mode of high flow and high negative pressure in phacoemulsification for white cataract

目的探讨以高流量高负压的爆破模式行白色白内障超声乳化手术的要点及效果。方法对23例（28眼）白色白内障采取高流量高负压的爆破模式行超声乳化手术，记录术中连续环形撕囊完成情况、超声能量、超声时间以及手术并发症；观察手术后的视力及角膜水肿情况。结果术中完整连续环形撕囊者20例25眼（89．29％），3例3眼（10．71％）发生前囊边缘撕裂；术中实际使用的超声能量为：（19．03±3．31）％，超声时间为（42±7）s，后囊破裂2例，均Ⅰ期植入人工晶状体，无1例发生核坠落、视网膜脱离或眼内炎等严重并发症；术后1周矫正视力：0．1者1例1眼（3．57％），0．3～0．4者7例7眼（25．00％），0．5～1．0者15例20眼（71．43％）。角膜水肿：0级者15例15眼（53．57％），1级者6例11眼（39．29％），2级者2例2眼（7．14％），无一例发生3级以上的角膜水肿。结论应用高流量高负压的爆破模式行白色白内障超声乳化术是一种高效，安全的方法。

Objective To investigate the effect of blasting mode of high flow and high negative pressure phacoemulsification for white cataract. Methods The blasting mode of high flow and high negative pressure phacoemulsification for white cataract was performed in 28 eyes of 23 cases, and the completion of continous curviliniar capsulorrhexis （CCC）, ultrasonic power, ultrasonic time and operative complications were observed alter the operation. The visual acuity and corneal edema were recorded. Results CCC was performed successfully in 25 eyes （ 89.29% ） , and the rupture of edge of anterior capsule occued in 3 eyes （10.71%）. The ultrasonic energy used in actual operation was （19.03% ± 3.31% ） and the ultrasonic time was （42 ± 7 ） s. Posterior capsular rupture happened in 2 eyes, and the intraocular lens were all implanted in the first stage. No serious complications such as nuclear fall, retinal detachment or endophthalmitis occurred. The visual acuity at 1 week after the operation was less than 0.3 in one eye （3.57%） , 0.3-0.4 in 7 eyes （25.00%） and 0.5-1.0 in 20 eyes （71.43%）. Corneal edema was grade 0 in 15 eyes （53.57%） , grade 1 in 11 eyes （39.29%） , grade 2 in 2 eyes （7.14%） , and corneal edema in grade 3 didn＇ t happen. Conclusion The blasting mode of high negative pressure and high flow phaeoemulsification for white cataract is effective and safe.