挤切劈核法在硬核白内障超声乳化术中的应用效果分析

Application of Crushing and Chopping Technique in Phacoemulsification to Hard Nuclear Cataract

目的 探讨挤切劈核法对硬核白内障超声乳化术中的应用效果。方法 对 2 0 0例 ( 2 19眼 )Ⅲ级以上的硬核白内障实施了挤切劈核技术 ,即在核中心将乳化针头嵌入核内深达 3 /4核厚度 [能量 5 0 %,负压 2 5 0mmHg( 1mmHg =0 13 3 3kPa) ] ,停止乳化利用负压吸引的作用固定晶状体核 ,用劈核器Chopper绕经核的 6点钟位赤道部进入核下 ,利用侧刃与乳化头相对应 ,二者用力使用挤和切的方式将核碎成 2块 ,最终碎成 6～ 8块 ,并逐一乳化吸除 (能量 60 %,负压 3 10mmHg)。配合正性粘弹剂充填前房下的连续环形撕囊 ;软壳技术 ;双辅助切口 ,双手器械分别注吸皮质等技术 ,平均超声乳化时间 1.2min。结果 术后视力≥ 0 .5者 2 0 3眼 ( 92 .69%) ;≥ 1.0者 110眼 ( 5 0 2 3 %) ,主要并发症为后囊破裂 17眼 ,角膜水肿 5眼 ,后发障 6眼。结论 挤切劈核技术是硬核白内障超声乳化术中有效的碎核方法之一 ,其操作简便、安全、有效、术后效果好。

Objective To discuss the effect of crushing and chopping in phacoemulsification on hard nuclear cataract. Methods 219 eyes of 200 patients with cataract, whose hard nucleus belonged to grade Ⅲ or higher, were operated with crushing and chopping technique,and then with phacoemulsification, and a series of sequent techniques such as continuous curvilinear capsulorrhexis plus fill up of anterior chamber with viscoelastic agent, were used. Results There were 203 eyes (92.69%) whose sight was higher than or equal to 0.5,and 110 eyes (50.23%) whose sight higher than or equal to 1.0.The main complications included posterior capsule rupture (17 eyes), after cataract (6 eyes) and corneal edema (5 eyes). Conclusion Crushing and chopping technique in phacoemulsification is an effective way to hard nuclear cataract, as well as its convenience and safety.