表面麻醉下手法劈核小切口白内障囊外摘除术在防盲治盲中的应用

Manual nucleus fragmentation and small incision extracapsular cataract extraction under surface anesthesia in blindness prevention and treatment

目的观察表面麻醉下手法劈核小切口白内障囊外摘除术在防盲治盲中的疗效及安全性。方法对80例(80只眼)白内障防盲患者在表面麻醉下行手法劈核小切口白内障囊外摘除联合人工晶状体植入术治疗,观察手术前后视力、散光值及术中术后并发症情况。结果术后1 d,视力≥0.3者63只眼(78.8%),≥0.5者26只眼(32.5%)。术后3个月视力≥0.3者69只眼(86.3%),≥0.5者43只眼(53.8%)。术后3个月,平均角膜散光值(1.10±0.31)D与术前平均角膜散光值(1.08±0.52)D比较无统计学差异(P>0.05)。术中后囊膜破裂3只眼(3.6%),角膜后弹力层脱离1只眼(1.3%)。术后角膜水肿5只眼(6.3%),反应性葡萄膜炎1只眼(1.3%),继发性高眼压2只眼(2.5%),未出现角膜内皮失代偿、感染性眼内炎及视网膜脱离等严重并发症。结论表面麻醉下手法劈核小切口白内障囊外摘除术术后恢复快,并发症少,安全有效,简单易行。

Objective To observe the therapeutic effects and safety of manual nucleus fragmentation and small incision extracapsular cataract extraction under surface anesthesia on blindness prevention and treatment. Methods Eighty patients（ 80 eyes） were performed with manual nucleus fragmentation,small incision extracapsular cataract extraction,and intraocular lens implantation under surface anesthesia. In these patients,visual acuity and astigmatism were measured before and after surgery,and surgical complications were observed. Results Visual acuity was ≥0. 3 in 63 eyes（ 78. 8%）and ≥0. 5 in 26 eyes（ 32. 5%） at 1 day after operation. Visual acuity improved to ≥0. 3 in 69 eyes（ 86. 3%） and ≥0. 5in 43 eyes（ 53. 8%） at 3 months. Average postoperative astigmatism was 1. 10 ± 0. 31 D at 3 months,and there was no significant difference when compared to preoperative astigmatism 1. 08 ± 0. 52D（ P〉0. 05）. Posterior capsular rupture occurred in 3 eyes（ 3. 6%）,and corneal Descemet＇s detachment occurred in 1 eye（ 1. 3%） during operation. Postoperative complications included corneal edema in 5 eyes（ 6. 3%）,reactive uveitis in 1 eye（ 1. 3%） and secondary high intraocular pressure in 2 eyes（ 2. 5%）. There were no severe complications such as decompensation of corneal endothelium,infectious endophthalmitis or retinal detachment. Conclusions The surgery is proved to be safe,effective and easy with rapid recovery and less complications.