摘要
目的评价改良小切口非超声乳化白内障囊外摘除联合人工晶状体植入治疗硬核白内障在白内障复明手术中的疗效.方法选择2014年4月至2016年4月在永州市第一人民医院眼科参加白内障复明手术的120例(214只眼)Ⅳ级及以上硬核白内障患者,行改良小切口非超声乳化白内障囊外摘除术(双手“跷跷板”法出核,联合手工劈核,小切口不缝合白内障囊外摘除),观察术中并发症、术后裸眼视力、眼压及术眼恢复情况.结果术中无后囊膜破裂及虹膜脱出发生,所有术眼均植入人工晶状体,切口不需缝合,术后部分患眼(21只眼)角膜出现轻度水肿,三天后消失.角膜内皮细胞计数丢失率约20%,无l例出现大泡性角膜病变.结论白内障手术虽然已经由复明手术逐渐转向屈光性手术,但是在偏远地区,很大一部分患者均是Ⅳ级及以上硬核白内障患者,对于这部分患者,如果拥有良好的超乳设备和高超的超乳技术也能完成手术,术后会有一定的角膜水肿发生.如果设备和手术技术一般,超声乳化手术可能会出现较严重的并发症.本研究对这部分患者采用改良小切口非超声乳化白内障囊外摘除联合人工晶状体植入术,取得了手术并发症少、术后反应轻、术眼恢复快的良好疗效.
Objective To evaluate the effects of improved small incision in non phacoemulsification cataract extraction combined with intraocular lens implantation in cataract surgery.Methods From April 2014 to April 2016,a total of 120 cases(214 eyes)ofⅣand above level cataract patients were chosen who were going to take cataract surgery at our hospital,and then non phacoemulsification small incision extracapsular cataract extraction were performed(by using hands"seesaw"method to carry out nuclear manual chop with small incision without suture extracapsular cataract extraction).The patients'status of intraoperative complications,postoperative visual acuity,intraocular pressure and postoperative recovery were observed.Results No rupture of membranes and iris occurred during the operations.Intraocular lenses were implanted in all the eyes.The incisions were not sutured.Some eyes(21 eyes)showed mild corneal edema,but it disappeared after three days.The rate of corneal endothelial cell loss was about 20%,and no bulbous keratopathy appeared.Conclusions The cataract extraction surgery has gradually turned to the refractive surgery,but in remote areas,a large part of the patients are gradeⅣand above cataract patients,for these patients,if they are treated with good medical equipment and excellent ultrasound emulsifying technology,they could recover after the operation.Yet,there will be some corneal edema after the operation.If they are treated with the equipment and surgical techniques which are ordinary,it may lead to more severe complications which brought by phacoemulsification.We use modified small incision in non phacoemulsification extracapsular cataract extraction and intraocular lens implantation in this group of patients.It turns out that this method has the advantages of less complication,less postoperative reaction and faster recovery of the eye.
作者
赵永旺
彭清华
唐云骢
Zhao Yongwang;Peng Qinghua;Tang Yuncong(Hunan University of Chinese Medicine,Chansa 410208,China;Department of Ophthalmology,the First People's Hospital of Yongzhou,Yongzhou 425000,China)
出处
《中国实用眼科杂志》
2018年第1期46-49,共4页
Chinese Journal of Practical Ophthalmology
关键词
改良
小切口
非超声乳化
硬核白内障
Improved small incision
Non-phacoemulsification
Hard nucleus cataract
作者简介
通信作者:赵永旺,Email:zywang1@126.com
