同轴伸缩式撕囊镊的设计及其临床应用

The application of the isoaxic extension and contraction capsulotomic forceps.

目的 观察同轴伸缩式撕囊镊在白内障手术中的使用效果。方法 将150例核硬度为Ⅱ～Ⅲ级的老年性白内障,随机分为Ⅰ、Ⅱ、Ⅲ组,每组50例。3组中又随机分为a组(观察组)和b组(对照组),各为25例。Ⅰ组用灌注液维持前房,Ⅱ、Ⅲ组用甲基纤维素维持前房。所有a组使用该器械撕囊,Ⅰb组使用截囊针头撕囊,Ⅱb、Ⅲb组使用常用撕囊镊撕囊。Ⅰ、Ⅱ组由撕囊技术成熟的医生施行,Ⅲ组由撕囊技术不成熟的医生完成。结果 撕囊成功率及撕囊所用时间在3组的a、b组之间比较,差异均有显著性意义。术中前房内注入甲基纤维素的次数在Ⅱ、Ⅲ组中a组较b组明显减少,差异有非常显著性意义。结论该器械结构简单、体积小、操作灵活,进入前房所需的切口小,前房密闭良好。

Objective To evaluate the effect of capsulotomic forceps with isoaxic extension and contraction.Methods 150 cases (150 eyes) with senile cataract were randomly divided into goup Ⅰ、Ⅱ、Ⅲ (50 eyes respectively) and each of them into group a and group b (25 eyes respectively) .Irrigational fluid and 2% HPMC were used in group Ⅰ and group Ⅱ、Ⅲ respectively. This kind of forceps 、 needle and common capsulotomic forceps were used in group a,group g11b and group Ⅱb、Ⅲb respectivly.Operation were undergone by experienced doctors in group Ⅰ、Ⅱ and by doctors with little experience in group Ⅲ . Results The difference of successful rate between group a and group b were significant( x2 = 5.71,6. 35,11.54; P < 0.05,0.05,0.01). There were still significant difference in operting time between group a and group b which got successful capsu-lorhexis(t = 5.72,3. 29,2. 22; P < 0. 01,0. 01,0. 05). Comparing with group Ⅱa、 Ⅲa, the use of 2% HPMC were fewer than group Ⅱb、Ⅲb,and the difference were significant (t = 8. 69,6. 75; P < 0. 01,0. 01). Conclusions The forceps with simple structure and small volume is easy to operate. As it needs small incision, the good closing of anterior chamber can be got, and the depth of anterior chamber can be keeped with irriga-tional fluid or 2% HPMC.This forceps can decrease the stuff expense, improve successful rate and short operating time.