中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2014年
5期
624-626
,共3页
连续环形撕囊%手法无缝线白内障囊外摘除%脱核
連續環形撕囊%手法無縫線白內障囊外摘除%脫覈
련속배형시낭%수법무봉선백내장낭외적제%탈핵
Continuous curvilinear capsulorhexis (CCC)%Extracapsular cataract extraction (ECCE)%Prolapse of nucleus
目的 探讨以连续环行撕囊方法制作大直径前囊口在手法无缝线白内障囊外摘除术中应用于Ⅳ级以上大硬核病例的安全性及有效性.方法 对2009年11月至2013年4月在怀化535医院眼科就诊的915例(1 236只眼)Ⅳ级及以上大硬核白内障患者行手法无缝线白内障囊外摘除手术,术中采用连续环行撕囊法制作7～8 mm直径前囊口,并对患者术中撕囊是否成功、后囊破裂、术后角膜水肿及视力等情况进行统计学分析,研究其手术价值.结果 1 236只眼有1 221只眼(98.8％)连续撕囊成功;10只眼(0.8％)囊膜瓣向周边撕裂不能挽救,留有放射状裂口一个;5只眼(0.4％)因为虹膜后粘连、囊膜钙化机化等原因,无法常规撕囊,采用囊膜剪开及截囊等方法完成前囊开口;4只眼(0.3％)发生＜1/4象限的后囊破裂.全部病例均顺利植入人工晶状体于囊袋内.术后一过性角膜水肿22只眼(1.8％),术后2个月视力≥0.5者1 038只眼(84％),≥0.3者1 174只眼(95％).结论 在手法白内障术中,用连续环形撕囊制作＞常规直径的前囊口治疗大硬核病例,使手术安全性提高,值得应用.
目的 探討以連續環行撕囊方法製作大直徑前囊口在手法無縫線白內障囊外摘除術中應用于Ⅳ級以上大硬覈病例的安全性及有效性.方法 對2009年11月至2013年4月在懷化535醫院眼科就診的915例(1 236隻眼)Ⅳ級及以上大硬覈白內障患者行手法無縫線白內障囊外摘除手術,術中採用連續環行撕囊法製作7～8 mm直徑前囊口,併對患者術中撕囊是否成功、後囊破裂、術後角膜水腫及視力等情況進行統計學分析,研究其手術價值.結果 1 236隻眼有1 221隻眼(98.8％)連續撕囊成功;10隻眼(0.8％)囊膜瓣嚮週邊撕裂不能輓救,留有放射狀裂口一箇;5隻眼(0.4％)因為虹膜後粘連、囊膜鈣化機化等原因,無法常規撕囊,採用囊膜剪開及截囊等方法完成前囊開口;4隻眼(0.3％)髮生＜1/4象限的後囊破裂.全部病例均順利植入人工晶狀體于囊袋內.術後一過性角膜水腫22隻眼(1.8％),術後2箇月視力≥0.5者1 038隻眼(84％),≥0.3者1 174隻眼(95％).結論 在手法白內障術中,用連續環形撕囊製作＞常規直徑的前囊口治療大硬覈病例,使手術安全性提高,值得應用.
목적 탐토이련속배행시낭방법제작대직경전낭구재수법무봉선백내장낭외적제술중응용우Ⅳ급이상대경핵병례적안전성급유효성.방법 대2009년11월지2013년4월재부화535의원안과취진적915례(1 236지안)Ⅳ급급이상대경핵백내장환자행수법무봉선백내장낭외적제수술,술중채용련속배행시낭법제작7～8 mm직경전낭구,병대환자술중시낭시부성공、후낭파렬、술후각막수종급시력등정황진행통계학분석,연구기수술개치.결과 1 236지안유1 221지안(98.8％)련속시낭성공;10지안(0.8％)낭막판향주변시렬불능만구,류유방사상렬구일개;5지안(0.4％)인위홍막후점련、낭막개화궤화등원인,무법상규시낭,채용낭막전개급절낭등방법완성전낭개구;4지안(0.3％)발생＜1/4상한적후낭파렬.전부병례균순리식입인공정상체우낭대내.술후일과성각막수종22지안(1.8％),술후2개월시력≥0.5자1 038지안(84％),≥0.3자1 174지안(95％).결론 재수법백내장술중,용련속배형시낭제작＞상규직경적전낭구치료대경핵병례,사수술안전성제고,치득응용.
Objective To evaluate the efficacy and safety of large sized continuous curvilinear capsulorhexis (CCC) applied in large or hard nucleus cases in manual sutureless extracapsular cataract extraction.Methods All eyes with Ⅳ or Ⅴ nucleus that underwent manual exttacapsular cataract extractions (ECCE) in which large sized continuous curvilinear capsulorhexis were performed from November 2009 to April 2013 were included in this study,the related complications such as capsule rupture,corneal edema and visual conditions were statistically analyzed and compared with the data of ECCEs with normal sized CCCs reported in the literature.Results Included in the study were 1236 eyes,of which 1221 eyes (98.8％) had successful CCCs up to 7-8mm in diameter,10 eyes had a radial tear which could not be saved when performing CCC,5 eyes had anterior capsule opened with a cystotome or a scissor due to capsule membrane calcification.4 eyes (0.32％) suffered from posterior capsule rupture; 22 eyes (1.8％) had transient corneal edema; 1038 eyes (84％) had the visual acuity ≥ 0.5 on the 2 months postoperatively,1174 eyes (95％) ≥0.3.The difference was statistically significant compared with the traditional ECCE (P ＜0.01).Conclusions Large CCC technique for large or hard nucleus cases in manual sutureless ECCE is safe and reliable,of high originality and a wider range of indications so that it is worthy of application in basic medical institutions.
