拨核挑核出核方法在手法小切口白内障复明手术中的应用

Application of manual toggling and picking out nuclear in small incision cataract surgery

目的介绍拨核挑核出核方法在手法小切口白内障复明手术中的应用。方法回顾应用拨核挑核出核方法对238例（268只眼）不宜进行超声乳化手术的白内障患者进行手法小切口白内障囊外摘除联合人工晶状体植入手术,观察术中、术后并发症及手术效果。结果所有患者无一例发生严重并发症。术后观察3个月,最佳矫正视力≥1.0者87只眼（32.46%）,0.5～0.9者167只眼（62.31%）,6只眼视力无提高（眼底病变）,其余视力均较术前提高,有效率97.76%。结论拨核挑核出核法在手法小切口白内障囊外摘除联合人工晶状体植入手术中是一种安全、有效、简单、实用的新方法。

Objective To introduce the clinical application of manual small incision cataract surgery（ MSICS） by toggling and picking out the nuclear. Methods This is a retrospective study in 238 cataract patients（ 268 eyes） who received manual small incision cataract surgery combined with intraocular lens implantation using a manual toggling and picking nuclear removal technique. All cases are contraindicated to conduct phacoemulsification cataract surgery. Statistics methods were used to analyze the postoperative complications and outcome. Results No severe postoperative complication was observed. Within 3-month follow up,the best corrected visual acuity was better than 1. 0 in 87 eyes（ 32. 46%）,between 0. 5 to 0. 9 in 167 eyes（ 62. 31%）. Except 6 eyes,remained the same（ Retinopathy）,Totally 97. 76% of the eyes obtained improved visual acuity after surgery,and 6 eyes remained unchanged in visual acuity. Conclusion Manual toggling and picking for nuclear removal is a safe,effective,simple and practical method that suitable in small incision cataract surgery.