CAJ | 학술논문

目的：总结在膨胀性白色白内障患者中应用囊膜染色技术联合囊袋减张法的临床经验，为眼科医师解决膨胀性白色白内障患者连续环形撕囊中的手术难点提供解决方案。方法前瞻性随机对照临床研究。收集2013年1月至2014年7月在西安市第四医院眼科白内障组进行白内障超声乳化手术的膨胀性白色白内障患者60例（60眼）。随机分成2组。撕囊过程中分别采取常规连续环形撕囊或囊膜染色技术联合囊袋减张方法处理后进行连续环形撕囊。比较两种方法的撕囊成功率、完成时间以及术前术后角膜内皮计数的差别。结果常规连续环形撕囊患者组30例（30只眼），囊膜染色联合囊袋减张组30例（30只眼）。两组患者平均年龄及性别构成比差异均无统计学意义（ P ＞0．05）。常规连续环形撕囊组5例未能完成撕囊，应用囊膜剪剪除残余部分囊膜，继续完成剩余部分超乳手术操作，其中2例患者出现因前囊膜撕囊不连续导致的后囊膜破裂；囊膜染色联合囊袋减张组1例出现无法完成连续环形撕囊，未出现因前囊膜撕囊不连续导致的后囊膜破裂，但比较两组撕囊连续性差异无统计学意义（ P ＞0．05）。常规连续环形撕囊组完成撕囊时间为（36．6±11．2） s，囊膜染色联合囊袋减张组完成整个操作的时间达（140．5±16．3）s，两组操作完成时间差异有统计学意义（ P ＜0．05）。手术前后两组患者角膜内皮细胞计数差异无统计学意义（ P ＞0．05）。结论囊膜染色联合囊袋减张法是解决膨胀性白色白内障连续环形撕囊难题的一种安全的临床方法。
목적：총결재팽창성백색백내장환자중응용낭막염색기술연합낭대감장법적림상경험，위안과의사해결팽창성백색백내장환자련속배형시낭중적수술난점제공해결방안。방법전첨성수궤대조림상연구。수집2013년1월지2014년7월재서안시제사의원안과백내장조진행백내장초성유화수술적팽창성백색백내장환자60례（60안）。수궤분성2조。시낭과정중분별채취상규련속배형시낭혹낭막염색기술연합낭대감장방법처리후진행련속배형시낭。비교량충방법적시낭성공솔、완성시간이급술전술후각막내피계수적차별。결과상규련속배형시낭환자조30례（30지안），낭막염색연합낭대감장조30례（30지안）。량조환자평균년령급성별구성비차이균무통계학의의（ P ＞0．05）。상규련속배형시낭조5례미능완성시낭，응용낭막전전제잔여부분낭막，계속완성잉여부분초유수술조작，기중2례환자출현인전낭막시낭불련속도치적후낭막파렬；낭막염색연합낭대감장조1례출현무법완성련속배형시낭，미출현인전낭막시낭불련속도치적후낭막파렬，단비교량조시낭련속성차이무통계학의의（ P ＞0．05）。상규련속배형시낭조완성시낭시간위（36．6±11．2） s，낭막염색연합낭대감장조완성정개조작적시간체（140．5±16．3）s，량조조작완성시간차이유통계학의의（ P ＜0．05）。수술전후량조환자각막내피세포계수차이무통계학의의（ P ＞0．05）。결론낭막염색연합낭대감장법시해결팽창성백색백내장련속배형시낭난제적일충안전적림상방법。
Objective To summarize the clinical experience of capsule dyeing and capsular decompression tech-niques before capsulorhexis in intumescent white cataract.To provide solutions for ophthalmologists to solve the difficulty of continuous curvilinear capsulorhexis in such cases.Methods This is a prospective randomized controlled clinical study. We collected clinical data from 60 intumescent white cataract patients who were hospitalized in Xi’ an No.4 hospital from January 2013 to July 2014.These patients were randomly divided into 2 groups.Capsulorhexis was done with either con-ventional continuous circular capsulorhexis (conventional group) or was preceded by capsule dyeing and capsular decom-pression methods then continuous circular capsulorhexis ( treatment group) .Capsulorhexis continuity, time and corneal en-dothelial cell numbers before and after surgery of two groups were compared.Results Each group contained 30 patients (30 eyes).The average age and gender composition had no statistical difference.Continuous curvilinear capsulorhexis could not complete in 5 patients in conventional group.Venus scissors was then required to finished capsulorhexis.After phacoemulisification, posterior capsular rapture occurred in 2 patients because of anterior capsular rapture.In comparison, continuous curvilinear capsulorhexis could not complete in only 1 patient in treatment group.Posterior capsular rapture did not occurred in this group.However, there was no statistical difference between two groups in capsulorhexis continuity.The average time of capsulorhexis in conventional group was 36.6 ±11.2 seconds, while it was 140.5 ±16.3 seconds in treat-ment group.There was statistical difference between the two groups.There was no statistical difference in corneal endothe-lial cell numbers before and after surgery.Conclusion The capsule dyeing and capsular decompression methods effective-ly improved the capsulorhexis for intumescent white cataract patients.