非超声乳化小切口囊外摘除术治疗伴高度近视的白内障

The clinical analysis of H-ECCE for cataract combined with high myopia

目的:评价无超声的水中囊外摘除术(H-ECCE)治疗伴高度近视的白内障的临床效果及并发症。方法:连续病例71例74眼,其中伴有高度近视(>-6.00DS)的白内障26例27眼作为Ⅰ组,其他病例作为Ⅱ组,行H-ECCE或H-ECCE+IOL植入术。术中将生理盐水注入在晶体核和后囊之间,边注水边轻轻旋转晶体核直到转出角巩膜缘切口(6～7mm)。即娩核始终在囊袋内进行,不需要压迫娩核法或晶体圈托出法,切口缝线通常为3～4针。Ⅱ组中4例4眼行超声乳化加IOL植入术。现察临床效果及并发症。结果:除去术前原有的黄斑陈旧出血或变性,糖尿病及青光眼性损害病例,Ⅰ组和Ⅱ组相比,术后矫正视力>0.5及>0.3的比率的差别无统计意义,后囊破裂发生率的差别亦无统计意义。无视网膜脱离,无浅前房发生。结论:H-ECCE娩核始终在囊袋内进行,术中无须器械进入前房,亦不需要压迫娩核,安全可靠、简单经济,可作为治疗伴有高度近视的白内障的常规首选术式之一。

Purpose:To evaluate the clinical result and complication of H-ECCE for cataract combined with high myopia.Methods;74 eyes of continuous 71 cases were divided into group A of 27 eyes of 26 cases with high myopia(>-6.0 DS)and group B of other cases.H-ECCE and H-ECCE + IOL were performed.The procedure for removal of cataracts was an infusion of BSS between the posterior capsule and the nucleus to rotate the nucleus out through an incision of 6 ~ 7mm.It avoided the expression contrapression maneuver or to introducing instruments into the eye.The wound was closed with 3 ~ 4 interrupted 10/ 0 nylon sutures.Phaco + IOL was performed in 4 eyes of 4 cases of group B.The results and complications were observed.Results:The difference of the rate of postoperative BCVA higher than 0.5 and 0.3 between the two groups was of no significance,except the case of glaucoma and preoperative conditions of macular degeneration and hemorrhage.There was no difference in the rupture of the post capsular in the two groups.There was no postopera-tive retinal detachment or shallow anterior chamber.Con-Clusions:H-ECCE is a safe,economical,and easy to perform procedure for cataract combined high myopia