摘要
目的 :评价对硬核 (IV+ / V)白内障采用囊外摘除法 (ECCE)的优点 ;探讨术中应用前囊连续环行撕囊 (CCC)后的娩核方法。方法 :角膜缘外 2 mm做一长 7～ 8mm巩膜隧道切口 ,行 CCC直径为 6～ 7mm,以“T”型晶体调位钩及自制撕囊针相互配合将直径 9mm左右的晶体核旋转脱位入前房 ,圈套器套核 ,囊袋内植入人工晶体。结果 :97眼中 94眼撕囊口娩核后仍平滑连续完整 ,囊袋内植入人工晶体 ;3眼发生前囊膜放射状撕裂并延至后囊 ,只有 1眼高度近视未植入晶体 ,另外 2眼仍囊袋内植入晶体。术后第一天 97眼角膜全部清亮 ,瞳孔圆 ,光反应正常。术后一周裸眼视力≥ 0 .5者 85眼占 87.6 %。结论 :对于硬核白内障 ,传统 ECCE仍有意义 ,CCC克服了开罐式截囊的缺陷 ,改进的娩核方法保持了撕囊口的平滑连续性 ,从而确保了囊袋内植入人工晶体 ,使其效果与 PHACO更接近 ,而投资却少 ,适合在基层医院推广。
Object:To evaluate the advantage of Extracapsular Cataract Extraction(ECCE)of IV +/V grade sclerotic nuclei cataract;to explore the method of nucleus delivery after Continuous Circular Capsularhexis(CCC).Methods:Through a sclera tunnel incision CCC and ECCE were performed in TV +/V grade sclerotic cataract.The nucleus of 9mm in diameter can be deliveried through a CCC opening of 6-7mm in diameter by using a modified technique for nucleus delivery.with a completely intact anterior capsular rim and capsular bag for IOL.implantation In-the-bag Results:97eyes with IV +/V grade nucleus cataract,94eyes have a completely intact capsular bag and IOL implantation In-the-bag.Only 3 eyes the anterior capsular occurred radial rim tear and resulted the posterior capsular rupture.Among that 1 eye(high myopia)was not implanted IOL,the others were still IOL implantation In-the-bag.At postoperative 1 day,97eyes corners are clear without oedema.The pupils are round and the reaction of pupil to light is good.At postoperative l week the visual acuities without correction 0.5 or better were obtained in 85 eyes(87.6%).Conclusion:The results suggest that the ECCE and CCC is very important to IV +/V grade nucleus cataract.The effect is closer to Phacomulsification(PHACO).However,it costs less and is more suitable to be popularizes in small hospital.
出处
《中国实用眼科杂志》
CSCD
北大核心
2001年第1期64-66,共3页
Chinese Journal of Practical Ophthalmology
