囊膜染色联合囊袋减张微小撕囊在膨胀性乳化白内障手术临床应用

Clinical application of capsular staining combined with capsular bag-reducing micro-capsulorhexis in expansive emulsifying cataract surgery

目的探讨膨胀性乳化白内障患者联合采用囊膜染色与囊袋减张微小撕囊手术的治疗效果。方法收集2018年4月~2019年12月在我院行超声乳化联合人工晶体植入术治疗的36例膨胀性乳化白内障患者的病历资料,采用回顾性分析的方式展开研究,18例对照组患者术中采用的撕囊方法为囊膜染色;18例观察组在此基础上联合囊袋减张微小撕囊,评价手术效果。结果观察组和对照组的撕囊时间分别为142.58±14.32s、36.17±10.86s,对照组的撕囊时间短于观察组(P<0.05)。两组术前、术后的角膜内皮计数、术后1个月的视力水平无明显差异(P>0.05)。观察组连续环形撕囊的完成率94.44%,对照组完成率为66.67%,二者之间差异存在统计学意义(P<0.05)。观察组和对照组的前囊膜撕裂分别为5.56%、33.33%,观察组发生率明显低于对照组(P<0.05)。结论对膨胀性乳化白内障患者而言,术中在采用常规囊膜染色撕囊的基础上,联合囊袋减张微小撕囊法,可以减少撕囊并发症出现,有效提高连续环形撕囊的完成率和手术安全性,值得临床推广。

Objective To explore the therapeutic effect of dilatation emulsification cataract patients combined with capsular staining and capsulotomy microcapsulotomy.Methods The medical records of 36 patients with expansive cataract treated by phacoemulsification combined with intraocular lens implantation in our hospital from April 2018 to December 2019 were collected,and the study was carried out by retrospective analysis.The capsulorhexis method used for the 18 patients in the control group during the operation was staining the capsular membrane;on the basis of this method,a combination with the capsular bag to reduce the microcapsulotomy is used for 18 cases in the observation group to evaluate the surgical effect.Results The capsulorhexis time of the control group(36.17±10.86s)was shorter than that of the observation group(142.58±14.32s),there was significant difference between the two group(P<0.05);There was no significant different in the corneal endothelial count and visual acuity level between the two groups before and after operation(P>0.05).However,the completion rate of continuous circular capsulorhexis in the observation group(94.44%)was higher than that in the control group(66.67%),The anterior capsule tears of the observation group and the control group were 5.56%and 33.33%,respectively.The incidence of the observation group was significantly lower than that of the control group(P<0.05).Conclusion For patients with expansive emulsifying cataract,on the basis of conventional capsular dyeing and capsulorhexis during the operation,combining with capsular bag-reducing microcapsulotomy can reduce the risk of complications and improve the success rate of continuous circular capsulorhexis,which is worthy of clinical expansion.