透明质酸酶及亚甲蓝在白内障防盲手术中的临床应用对比

The study of hyaluronidase acid and methylene blue in cataract operation

目的探讨白内障防盲手术中透明质酸酶和亚甲蓝染色对麻醉效果和连续环形撕囊成功率及对手术效果的影响。方法 100例(100眼)白色白内障随机分为2组进行前瞻性研究。球周麻醉中加入透明质酸酶及改良亚甲蓝前囊膜染色组53例,对照组(球周麻醉中不加入透明质酸酶和前囊不染色)47例。球周麻醉后,行现代白内障囊外摘除及人晶状体植入术。比较环形撕囊成功率、术中并发症、术后反应情况、视力、眼压。结果 2组术中撕囊成功率及人工晶状体体囊袋内植入率均有差别,与对照组相比差异有统计学意义;2组术后反应情况、视力、眼压无统计学意义。结论球周麻醉中加入透明质酸酶及改良亚甲监染色明显提高连续环形撕囊成功率。降低白内障手术并发症,无明显副作用,且廉价易得,适合在防盲白内障手术中推广。

Objetive To investigates the effect and influence of the hyaluronidase and methylene blue staining in cataract surgery on the anesthesia and the result of the operation. Method 100 cases（100 eyes） were randomly divided into 2 groups for a prospective study. There are 53 cases with the anterior capsule membrane staining of modified methylene blue and hyaluronidase in the peribulbar anesthesia. Control group is made of 47 cases that no staining and hyaluronidase in the anesthesia were used. After anesthesia, the modern extracapsular cataract extraction and intraocular lens implantation were performed. The success rate, complications, postoperative reaction, visual acuity and intraocular pressure were compared. Result The success rates of the 2 groups were different. The success rate of the capsulorhexis and the implantation rate of IOL were different, and the difference was statistically significant. There was no difference of he postoperative reaction, visual acuity and intraocular pressure between 2 groups. ConclusionThe success rate of capsulorhexis was significantly improved by the addition of hyaluronidase and modified methylene staining. And the complications of cataract operation are reduced. There is no obvious side effect. It is cheap, suitable for promotion in large-scale cataract operation.