白内障手术中后囊硬性斑的处理

Management of hard spot of posterior capsule in cataract operation

目的 探讨白内障患者后囊“硬性斑”的诊断及处理方法。方法 根据术前裂隙灯检查和手术中证实硬性斑的不同情况 ,选择后囊处理方式 ;首选“oerHi”环形撕囊仪环形撕囊 ,次之选用刺开撕囊 ,特殊的硬性斑用不同的环形切囊法。结果 oerHi环形撕囊仪 5眼无 1眼出现玻璃体溢入晶状体囊袋内、而刺开撕囊 2眼有 1眼玻璃体溢入晶状体囊袋内、环形切囊 2眼均出现玻璃体溢入晶状体囊袋内 ,给予前段玻璃体切除 ,本组 9眼人工晶状体均植入晶状体囊袋内。结论 用oerHi环形撕囊仪环形撕后囊“硬性斑” ,安全、简便。刺开撕囊时 ,勿伤及玻璃体前膜 ,深度掌握有难度 ,环形撕囊时需做前段玻璃体切除准备。

Objective To investigate the diagnosis and management of hard spot of posterior capsule in cataract patients. Methods According to different degree of hard spot of posterior capsule (evidence of slightlamp microscope's examination and operation),various management were selected.First,the continuous curvilinear capsulorhexis with oerHi,second,the capsulorhexis with cut, third,capsulotomy (special hard spot). Results In 9 cases,no vitreous overflow for 5 with the continuous curvilinear capsulorhexis,vitreous overflow in 1 of 2 cases with the capsulorhexis with cut,vitreous overflow in 2 cases with capsulotomy.Intraocular lenses were implanted in capsular bag in all of the cases.Conclusion The continuous curvilinear capsulorhexis is simple and safe.The capsulorhexis with cut has a certain difficulty.The capsulotomy should has preparation for anterior vitrectomy.