白内障超声乳化术中后囊膜破裂风险因素分析

Risk Factors of Posterior Capsule Rupture in Phacoemulsification

目的分析白内障超声乳化术中后囊膜破裂风险因素。方法对2016年1月—2017年12月在该院进行超声乳化手术的135例白内障患者的151只眼进行总结分析,对患者术中后发生后囊膜破裂的情况进行统计,将发生后囊膜破裂患者的临床资料与未发生后囊膜破裂患者的临床资料进行对比,并分析后囊膜破裂的风险因素。结果 135例患者中有6例患者发生术中后囊膜破裂,发生率为4.44%。其中,娩核时切口偏小、截囊时晶体脱位、吸皮质时瞳孔太小是影响后囊膜破裂的危险因素,发生术中后囊膜破裂与未发生术中后囊膜破裂的患者在上述3个方面的比较,后囊膜破裂组娩核时切口偏小66.67%、截囊时晶体脱位66.67%、吸皮质时瞳孔太小16.67%与未发生后囊膜破裂组比较差异有统计学意义(χ~2=5.174、6.734、、4.875,P<0.05)。结论娩核时切口偏小、截囊时晶体脱位、吸皮质时瞳孔太小是与后囊膜破裂密切相关的风险因素。手术时应十分注意这些因素的影响以将术中后囊膜破裂的发生率降至最低。

Objective To analyze the risk factors of posterior capsule rupture in phacoemulsification. Methods A total of 151 eyes of 135 cataract patients who underwent phacoemulsification in the hospital from January 2016 to December 2017 were analyzed. After the occurrence of posterior capsule rupture, the clinical data of patients with posterior capsule rupture were compared with the clinical data of patients without posterior capsule rupture, and the risk factors of posterior capsule rupture were analyzed. Results 6 of 135 patients developed intraoperative posterior capsule rupture with an incidence of 4.44%. Among them, the incision was small when the nucleus was delivered, the dislocation of the lens during the capsular sac, and the pupil was too small when the cortex was taken. It was a risk factor for the rupture of the posterior capsule. In the case of intraoperative capsular rupture and no rupture of the posterior capsule, compared with the above three aspects, the posterior capsule rupture group had a small incision of 66.67%, a dislocation of the lens at 66.67%, and a cortical thickness of 16.67%, which was statistically significant compared with the group without posterior capsule rupture(χ^2=5.174, 6.734, 4.875, P<0.05). Conclusion The small incision during the nucleus, the dislocation of the lens during the capsular sac, and the small pupil at the time of cortical is a risk factor closely related to posterior capsule rupture. Attention should be paid to the effects of these factors during surgery to minimize the incidence of postoperative intracapsular rupture.