改良小切口劈核技术在硬核性白内障手术中的应用医学论文.docVIP

改良小切口劈核技术在硬核性白内障手术中的应用 】探讨改良巩膜隧道小切口劈核技术在硬核性白内障非超声 乳化手术中的意义。 方法】1 1 2例（1 2 1眼）IV?V级硬核性 白内障采取改良手法劈核行巩膜隧道小切口非超声乳化摘除人工晶 体植入手术，回顾性分析了手术中劈核情况、术后视力及手术并发症。 结果】1 0 5眼一次劈核成功，1 6眼劈核后底部未完全分离但 出核时分成两瓣顺利娩出。术后两周视力大于0. 3者9 8眼，大于 0 . 1者1 1 3眼，术后轻度角膜水肿2 5眼，中度角膜水肿1 3眼。 结论】硬核性白内障小切口非超声乳化手术中应将硬核分成两部 分，使直径变小后再娩出，改良手法劈核无需特殊器械、操作简便、 安全实用。 关键词】小切口硬核性白内障 Abstract: Objective】 To evalu ate the application of nuclear m anua 1-chop technique modified w ith small incis ion in non-phacoe mulsification of hard catarac t. Methods】 It was performed in 1 12 cases (121 eyes) of age-relate d cataract with nucleus in grade I V ~ V in non-phacoemulsification nuclear manual-chop through scl e r a 1 turnel incis ion. A ret rospe ctive study was carried in the c ondition of splitting core, post -operative visual acuity and com plications. Results】 The nucle i of 10 5 patients were success fu 1 1 y divided into two sections w i t h nuclear manual-chop techniqu e a t one time, in the other 16 eye s, the bottom of the nuclei was n o t totally isolated at one time, but it was completed when the n u c 1 e u s were extracted. The p o s t - o perative visual acuity of 98 eye s was over 0. 3 and 113 eyes over 0 . 1 two weeks later. Mild post-op erative cornea 1 edema happened in 25 eyes and moderate pos t-ope rat i v e corneal edema in 13 eye s. Conclusions】 Nuclear m a n u a 1 - chop with small incis ion in non- phacoemuls i f icat ion of hard cat a r a c t can successfully divided the nuclei into two sect ions whi c h can be extracted more easily, Manual-chop technique modified could be performed without spec i a 1 instrument. It is quick, s a f e and effective. Key words: small incis ion; h a r d cataract; manual-chop 虽然随着白内障摘除人工晶体植入手术技术的提高，白内障超声 乳化手术因其切口愈合快、术后散光小及视力恢复快等优势已成为白 内障手术的主流方向，但是，对于IV、V级硬核性白内障采用超声乳 化手术因其术后严重角膜水肿影响复明效果，而采用小切口非超声乳 化手术方式是一个合理的选择。日本学者M omos e和Aka ra 曾报道巩膜隧道小切口手法劈、碎核技术［1 ］。我们在2 0 0 4年 9月至2 0 0 7年1 0月对硬核性白内障采用改良的劈核技术进行 小切口非超声乳化摘除人工晶体植入手术取得了较好的复明效果，现 将结果报道如下。 1材料和方法 1.1临床资料 11 2例1 2 1眼