吲哚青绿在白色白内障超声乳化吸除术中的应用

Use of indocyaine green staining technique for phacoemulsification in white cataract

目的 评价吲哚青绿在白色白内障超声乳化吸除术中应用的有效性和安全性。方法对 10 5例 (10 5只眼 )白色老年性白内障患者行超声乳化白内障吸除术 ,Ⅰ组 (5 5只眼 )术中使用 0 5 %吲哚青绿溶液染色晶状体前囊膜 ;Ⅱ组 (5 0只眼 )术中不使用染色剂。记录术中完成连续环形撕囊(CCC)的时间 ,晶状体前囊膜放射状撕裂、晶状体囊袋破裂、人工晶状体囊袋内固定情况 ,以及术前、术后 1d、术后 3个月术眼眼压 ,角膜内皮变化和眼前节炎性反应情况。结果 术中平均CCC时间Ⅰ组明显短于Ⅱ组 ,晶状体前囊膜放射状撕裂和晶状体囊袋破裂的发生率Ⅰ组明显低于Ⅱ组 ,人工晶状体囊袋内固定率Ⅰ组高于Ⅱ组 ,两组比较差异均有显著意义 (P <0 0 5 )。两组术后均无眼压升高者 ,角膜始终保持透明 ,炎性反应轻微 ;手术前、后角膜内皮细胞密度、六角形细胞百分比、面积变异系数及中央角膜厚度两组比较 ,差异均无显著意义 (P >0 0 5 )。结论 在白色白内障超声乳化吸除术中应用吲哚青绿晶状体前囊膜染色技术 ,可提高手术的成功率 ,且效果安全、可靠 ,建议临床推广使用。

Objective To evaluate the efficiency and safety of indocyaine green (ICG) staining technique using in white cataract phacoemulsification. Methods In a prospective clinical study, 105 eyes with white senile cataract were divided into two groups: capsular-staining group using ICG ( n =55) and noncapsular-staining group ( n =50). The time for performing the circular continuous capsulorrhexis (CCC), the number of radial tears of anterior capsule, the number of the rupture of capsular bag and the incidence of IOL in-the-bag fixation during the operation were recorded. We also measured the intraocular pressure and observed the changes of corneal endothelial cells, the anterior chamber flare and the keratic precipitation before surgery, 1 day and 3 months after surgery, respectively. The results of these two groups were compared. The quantitative results were analyzed with two-tailed student′s t-test, while the qualitative results were analyzed with chi-square test. Results In operations performed with ICG staining technique, the CCC could be performed more quickly, no radial tears of the anterior capsule or rupture of capsular bag occurred and all IOL could be fixed in the bag. No statistically significant difference could be detected in the occurrence of these four aforementioned changes between these two groups. None of these patients had an elevation of intraocular pressure. The anterior chamber flare, the corneal endothelial cell density, the percentage of hexagonal cells and the corneal thickness showed no statistically significant difference between these two groups before and after surgery. Conclusion Indocyaine green dye staining is a safe and useful technique in the white cataract phacoemulsification. We suggested to use ICG staining technique in the white cataract phacoemulsification.