前囊膜T形切开撕囊法在白色白内障超声乳化手术中的应用

Novel T-shaped capsulorrhexis in phacoemulsification surgery for patients with white cataract

目的：探讨前囊膜T形切开撕囊法在白色白内障超声乳化手术中的应用。方法：对49例53眼白色白内障患者在行超声乳化白内障摘除术时施行前囊膜T形切开撕囊法。在上方晶状体前囊膜上三分之一的位置,经上方巩膜隧道切口用自制4号半截囊针头或15°角膜穿刺刀自11∶00~1∶00方位弧形切开,注吸针头吸除前房及囊袋内液化的皮质,用囊膜剪自前囊膜切口的中央向晶状体前极方向做垂直切开,使前囊膜开口呈倒＂T＂形,用撕囊镊夹住一端瓣膜,顺时针或逆时针完成后续环形撕囊。结果：53眼白色白内障患者有45眼采用前囊膜T形切开撕囊法顺利完成后续环形撕囊,成功率达84.91%。结论：前囊膜T形切开撕囊法可以降低白色白内障晶状体囊袋内张力,清除液化皮质对手术野视线的影响,并达到环形撕囊的目的,是一种安全、简便而有效的操作方法。

Objective：To investigate the efficiency of novel T-shaped capsulorrhexis in phacoemulsification surgery for patients with white cataract.Methods：A total of 53 eyes of 49 patients with white cataract underwent phacoemulsification surgery by novel T-shaped capsulorrhexis via topical scleral tunnel incision at the one third of anterior lens capsule.Then the capsule was curvedly incised from 11 to 13 o’clock position with 15° stab knife,followed by cataract infusion-suction needle to remove the colliquative cortex in the anterior chamber and lens bags.In the middle of the curved incision,the capsule was vertically incised to the anterior lens with vannas capsulotomy to make the incision into inversus T-shaped.Subsequently,circular capsulorhexis was performed in clockwise or counterclockwise fashion by clamping one tip of the capsule membrane.Results：T-Shaped capsulorrhexis was completed in 45 of53 eyes.The successful rate was 84.91%.Conclusion：Novel T-shaped capsulorrhexis has several advantages,including easy reducing the tension of the lens bags in the patients with white cataract and removing the obstacle of the colliquative cortex in wider operative field as well as safe and simple completion of circular capsulorhexis.