台盼蓝二次染色在白内障超声乳化术中的临床应用

Clinical application of trypan blue two-times staining in phacoemulsification

目的:探讨白内障超声乳化加人工晶体植入术中使用台盼蓝二次染色对晶体前囊膜、后囊膜的标识、识别作用,提高手术安全。方法:随机收集2015年6月至2018年6月我院手术治疗100例(眼)白内障,分成台盼蓝二次染色组50例(眼)(实验组)和非染色组(对照组) 50例(眼),染色组采用前房气泡下染色和囊膜下第二次染色,观察术中前囊膜撕囊的丢失、撕裂,撕囊口大小是否连续、均圆,观察术中台盼蓝二次染色在后囊膜的标识和给术者的识别。结果:实验组50例(眼)均获得满意染色,染色后的晶状体前囊膜呈淡蓝色,后囊膜经二次染色后呈范围大小不一的斑驳状,观察撕囊的丢失、后囊膜破裂并玻璃体脱出、IOL囊袋内植入,实验组全部撕囊成功;对照组中有7例未能完成撕囊,3例后囊膜误超破囊,3例IA时误吸后囊破囊,6例破囊后人工晶体植入睫状沟。结论:台盼蓝二次染色对白内障超声乳化加人工晶体植入手术中晶体前、后囊膜的标识,术中对囊膜识别,特别是对于过熟期白内障(囊膜皱缩,钙化,晶体膨胀)等囊膜异常的白内障手术作用尤大,对超声乳化术中的前房内操作、核块在前房的层次、手术立体感的建立有极大辅助作用,提高了手术安全性。

Objective: In order to improve the safety of surgery, the clinical application of trypan blue two-times staining were investigated in the phacoemulsification, in which the anterior capsule and posterior capsule were stained by trypan blue. Methods: A total of 100 cases (100 cataracts) were recruited from our hospital between June 2015 and June 2018 using a clinical case-control study, in which they were randomly divided into trypan blue two-times staining group (50 cases, Test group) and no staining group (50 cases, Control group). In the staining group, the anterior capsule was stained with anterior chamber air bubbles and the posterior capsule was stained for the second time under the capsule. It was studied for the staining effects of lens capsule, the success rate of continuous curvilinear capsulorhexis, the integrity of capsule ring. Results: In staining group, 50 cases (eyes) were satisfactorily stained. The anterior capsule of the lens was light blue. After the secondary staining, the posterior capsule was stained with a variegated range of different sizes. All the cases in the experimental group succeeded in capsulorhexis. However, the capsulorhexis could not be completed in 7 cases of the control group. The posterior capsules were broken during phacoemulsification in 3 cases and IA aspiration in 2 cases of the control group. Conclusions: Trypan blue two-times staining which accentuated the visualization of the anterior and posterior capsules appears to be a safe technique to facilitate the manipulation of the whole phacoemulsification surgery, which greatly improves the safety of the operation.