改良式小切口囊外摘除术治疗过熟期核下沉白内障临床观察

The clinical effect of improved small incision extracapsular cataract extraction for the hypermature stage cataract

目的观察改良式小切口囊外摘除治疗过熟期核下沉白内障的临床效果。方法对2000年1月至2014年12月在萍乡市人民医院眼科就诊的39例（39只眼）过熟期核下沉白内障小切口囊外摘除时，术中破囊前先于晶状体囊袋内注入黏弹剂，再做弧形截囊及弧形囊膜剪作类圆形前囊膜剪除，行白内障手术，囊袋内注入人工晶状体结果36只眼（92．3％）术后矫正视力提高至0．02～0．8，3只眼（7．7％）因合并晶状体溶解性青光眼术后视力无变化。术中：玻璃体脱出2只眼（5．1％），术后：角膜内皮水肿13只眼（33．3％），前房有纤维性渗出8只眼（20．5％），前房积血3只眼（7．7％），眼压高11只眼（28．2％）。结论改良式小切口囊外摘除术治疗过熟期核下沉白内障，能有效地减少手术并发症，是一种安全、可靠的手术方式，明显地提高了手术的成功率。

Objective To investigate effect of improved small incision extracapsular cataract extraction for the hypermature stage cataract. Methods The small incision extracapsular cataract ex- traction and capsulectomy were applied on 39 eyes. Results The visual acuity was improved to 0.02-0.8 in 36 eyes among 39 eyes, 3 eyes had no changes combined with phaeogenic glaucoma. During the surgery, prolapse of vitreous happened in 2 eyes （5.1%）. Postoperative complications： cor- neal endothelium edema in 13 eyes （33.3%）, 8 eyes （20.5%） with fibrinous exudation in anterior chamber, hyphema in 3 eyes （7.7%）, intraocular hypertension in 11 eyes （28.2%）. Conclusions The improved small incision extracapsular cataract extraction is a safe and reliable modus operandi, which can reduce the occurrence of complications and raise the success rate significantly.