激光乳化白内障吸除术的初步临床观察

The preliminary study of photolysis for cataract surgery

目的 探讨使用掺钕钇铝石榴石激光乳化系统行激光乳化白内障吸除术的有效性和安全性。方法 使用Dodick ARC激光乳化仪对晶状体核硬度为N1 .0 ～N4.0 级 (LOCSⅢ白内障分类系统 )的白内障患者 52例 (52只眼 )行激光乳化白内障吸除折叠式人工晶状体植入术。手术前、后行常规眼科检查 ,记录术中情况、视力、角膜厚度及手术并发症情况。术后随访时间 >6个月。结果在全部术眼中 ,顺利完成手术 2 8只眼 ,术中改术式为超声乳化 2 4只眼 ,晶状体后囊膜破裂 2只眼 ;术后重度角膜水肿 3只眼 ,1～ 2周后缓解。术前视力 <0 0 5者 1 9只眼 ,0 0 5～ 0 3者 2 8只眼 ,0 4～0 5者 5只眼 ;术后视力≤ 0 3者 1只眼 ,0 4～ 0 5者 1 2只眼 ,0 6～ 0 9者 2 5只眼 ,≥ 1 0者 1 4只眼。平均角膜厚度术前为 0 59mm ,术后 3个月为 0 60mm ,两者比较差异无显著意义 (P =0 0 97)。结论使用Dodick ARC激光乳化仪行激光乳化白内障吸除术是治疗白内障安全、有效的方法 ;

Objective To evaluate the safety and efficiency of Dodick ARC photolysis machine (a kind of Nd:YAG laser system) in the using of cataract surgery Methods 52 eyes of cataract (fifty two patients) were undergone photolysis with Dodick ARC laser system and foldable intraocular lenses (IOLs) implantation The hardness of nuclei was graded as N 1.0 to N 4.0 of LOCS Ⅲ classification system Before and after operations, the intraocular conditions, visual acuity, corneal thickness and operative complications were recorded The time of follow ups was more than 6 months Results The operations were accomplished in 28 eyes and were changed into Phacoemulsification in 24 eyes Posterior capsule rupture occurred in 2 cases (3 8%) Severe corneal edema was found in 3 cases (5 8%) that disappeared in 1 to 2 weeks Preoperative visual acuity was <0 05 in 19 cases, 0 05 0 3 in 28 cases and 0 4 0 5 in 5 cases Postoperative visual acuity was ≤0 3 in 1 case, 0 4 0 5 in 12 cases, 0 6 0 9 in 25 cases and ≥1 0 in 14 cases The mean values of pachymetry was 0 59 mm preoperatively and 0 60 mm in 3 months postoperatively ( P =0 097) Conclusion Photolysis using Dodick ARC Nd:YAG laser system is a safe and effective method for cataract surgery The further improvement of equipments and surgery techniques is needed