摘要
为研究有白内障囊外摘除经验的眼科医师学习超声乳化吸出技术及其临床疗效，对７２眼白内障行超生乳化。结果：①连续环形撕囊３９眼占５４．２％；撕囊失败改为开罐式截囊２４眼占３３．３％；开罐式截囊９眼占１２．５％。②乳化晶体核６９眼占９５．８％，平均乳化时间和能量分别为４分４０秒±１分９秒及１５．５７％±８．２７％；负压为４０ｍｍＨｇ～８０ｍｍＨｇ；３眼因浅前房、瞳孔小和初学者的恐惧心理改为手法娩核。③术中最常见的合并症为后囊破裂，９眼占１２．５％，其中玻璃体脱出８眼占１１．１％；虹膜根部解离１眼占１．４％。④术后第１天最常见合并症是角膜水肿，１９眼占２６．４％，均在１周内消退。术后１周时，矫正视力≥０．５者６０眼占８３．３％；≥１．０者４８眼占６６．７％；＜０．５者１２眼占１６．７％，其中伴有眼部其他疾病（ＯＲ＝５．２９，９５％ＣＩ：２．７６～７．８２，Ｐ＜０．０００１）和术中出现后囊破裂（ＯＲ＝３．２６，９５％ＣＩ：１．０９～５．４４，Ｐ＝０．００３）是造成术后早期视力不佳的危险因素。结论：有白内障囊外摘除经验的眼科医师，过渡到超声乳化吸除术是完全可能的，最初的超声乳化获得了满意的结果。选择合适的病例，重点掌握?
Objective: To study the surgical techniques and therapeutic effects of phacoemulsification by surgeons with experienced extracapsular cataract extraction.Methods:The first 72 cataract operations using phacoemulsification were performed by experienced surgeons.Results:① Continuous curvilinear capsulorhexis was successfully completed in 39 eyes(54 2%);failure of capsulorhexis necessitated conversion to a can opener technique in 24 eyes(33 3%);can openner technique was performed in 9 eyes(12 5%).②Phacoemulsification was successfully completed in 69 eyes(95 8%),mean phacoemulsification times and power were 4 40 minutes±1 9 minutes and 15 57%±8 27%,respectively;the aspiration ranged from 40mmHg～80mmHg;3 unsuccessful cases were related to shallow anterior chamber,small pupil size and a surgeons fear of phacoemulsification.③ A rupture in the posterior capsule was the most frequent intraoperative complication,occurring in 9 eyes(12 5%)and 8 eyes(11 1%)with vitreous loss;iridodialysis occurring in 1 eye(1 4%)due to shallow anterior chamber.(4)Cormeal edema was noted on the first postoperative day in 19 eyes(26.4%).At one week,the visual acuities with correction were 0 5 or better in 60 eyes(83 3%);1 0 or better in 48 eyes(66 7%);and less than 0 5 in 12 eyes(16 7%).Other ocular disease(odds ratio 5 29,95%CI:2 76～7 82,P<0 0001)and intraoperative posterior capsular rupture(odds ratio 3 26,95%CI:1 09～5 44,P=0 003) were statistically significant factors for poor visual acuity.Conclusion:It is possible that the surgeons with experienced extracapsular cataract extraction can learn and perform phacoemulsification.Factors identified in the first surgeries as critical in the smooth transition to phacoemulsification were careful selection of initial cases,a successful capsulorhexis,emulsification of lens nucleus,and prevention of posterior capsular rupture.
出处
《中国实用眼科杂志》
CSCD
1999年第2期85-88,共4页
Chinese Journal of Practical Ophthalmology
关键词
内白障囊外摘除
超声乳化术
Catarct extraction capsulorhexis phacoemulsification complications
