小切口白内障手术中普通器械劈核法的应用

The clinical application of chopping nucleus with common instrument in small-incision surgery

目的 探讨应用普通晶状体圈匙和虹膜恢复器劈核在硬核白内障小切口非超声乳化人工晶状体植入术中的临床效果。方法 于上方角膜缘后 2mm处作直线形巩膜隧道切口 ,长约 5 5mm ,剖至透明角膜内约 1mm ,不作侧切口。开罐式截囊或连续环形撕囊 ,水分离后使晶状体核浮至前房 ,以晶状体圈匙进入核下方并向上托住核 ,虹膜恢复器进入前房至核的上方向下用力切割 ,双手配合将核劈为两半 ,分别托出。结果 97例 97眼术后第 1天视力≥ 0 .5者 62眼 ( 63 9% ) ,术后 1周82眼 ( 84 5 % ) ,术后第 1天角膜水肿 2 5眼 ( 2 5 7% ) ,3～ 5天内水肿完全消失。随访 6～ 12月无并发症。结论 此法不需特殊器械 ,操作方便 ,安全有效 ,便于推广。

Objective To observe the clinical effect of chopping nucleus with common lens loop and iris reposition instrument in small incision nonphacoemulsification hard nucleus cataract surgery.Methods About 2.0 mm to the upper limbus,5.5 mm wide straight liner shape sceral tunnel incision was made and extended into the transparent cornea 1.0 mm.After can openner or continuous curvilinear capsularhexis was carried out,the nuclear was floated to the anterior chamber.The nuclear was chopped into two pieces with the lens loop under the nucleus and iris reposition on the nuclear and taken out.Results Of the 97 eyes,the visual acuity was 0.5 or better in 62 eyes(63.9%) on the first day after the operation and 83 eyes on the first week.25 eyes had localized cornea edema on the first day after the operation,and became transparent in three to five days after the operation.The postoperative follow-up was 6 to 12 months, no complication which affected visual acuity was observed.Conclusion The common instrument nucleus chopping is safe,convenient and easy for extensive basic hospital.