后囊连续环形撕囊在防治儿童人工晶状体植入术后后囊混浊中的作用

目的 探讨后囊连续环形撕囊在预防儿童白内障人工晶状体植入术后后囊混浊中的作用。方法 对29例29眼儿童白内障在植入人工晶状体后行一期后囊环形撕囊，术后随访3个月－2a。结果 术后随访显示27眼获得视轴透明区，眼底可见，矫正视力均有不同程度的提高。结论 一期后囊连续环形撕囊是预防儿童白内障人工晶状体植入术后后囊混浊的可行方法。     

白内障术中后囊连续环形撕囊预防后囊混浊的临床观察

目的 探讨白内障囊外摘除联合人工晶状体植入术中行后囊膜连续环形撕囊(PCCC)对预防术后后囊混浊(PCO)的作用。方法 对365例(426只眼)白内障行常规囊外摘除后行后囊膜连续环行撕囊再植入人工晶状体。结果 365例(426只眼)后囊膜连续环形撕囊均成功，人工晶状体植入囊袋中。术后随访2～3年后囊混浊未见发生。结论 在白内障囊外摘出后对后囊膜连续环形撕囊是可行的，它避免了后囊混浊产生的根本原因，对人工晶状体植入后视力无明显影响。     

环形撕囊直径与晶状体前、后囊膜混浊的临床研究

采用连续环形撕囊及人工晶状体囊袋内植入术 ,能有效防止人工晶状体偏心 ,减少人工晶状体对周围组织的损伤。但是术后晶状体前囊膜的环形混浊对眼底病检查和治疗的影响、不同撕囊直径对后发性白内障的影响不同等 ,成为这一技术带来的新问题。本文通过研究撕囊直径大小对老年性白内障术后晶状体前、后囊膜混浊及囊袋收缩程度的影响 ,探讨白内障摘除术中最佳的撕囊直径。1.资料和方法 :(1)对象与分组 :将 110例 (110只眼 )于我院行超声乳化白内障吸除人工晶状体植入术 ,术中连续环形撕囊的老年性白内障患者根据撕囊直径分为 3组 :Ⅰ组 4 3例 ,…     

儿童白内障后囊撕囊及人工晶状体后囊嵌顿术

目的研究儿童白内障摘出术中后囊处理方法。方法对26例(38眼)儿童白内障手术中采用后囊连续环形撕囊联合人工晶状体视区后囊嵌顿,术后随访(14±4.51)月。结果34眼后囊连续环形撕囊联合人工晶状体后囊嵌顿成功。此34眼中18眼玻璃体前界膜完整,16眼行前段玻璃体切除。经随访2眼术后3月视轴区玻璃体前界膜轻度浑浊,其余32眼视轴区保持透明。结论后囊连续环形撕囊联合人工晶状体视区后囊嵌顿是预防儿童白内障人工晶状体植入术后后囊浑浊,减少对玻璃体、视网膜干扰的可行方法。     

台盼蓝囊膜染色剂在白内障连续环形撕囊手术中的应用

目的研究台盼蓝囊膜染色剂在治疗白色白内障中,是否有助于连续环形撕囊的顺利完成及白内障手术的顺利进行。方法79例(80眼),随机分为2组,染色组40例(41眼),对照组39例(39眼),染色组使用台盼蓝囊膜染色剂,术中观察及对比前囊膜染色情况、连续环性撕囊成功率、晶状体后囊破裂及人工晶状体囊袋内植入情况,术后视力、前房炎症反应、角膜、人工晶状体有无蓝染及后囊混浊情况。并与对照组进行统计学分析。结果染色组的术中染色均匀,连续环形撕囊及人工晶状体囊袋内植入率为97.7%,晶状体后囊破裂率为2.44%,与对照组进行统计学分析有显著差异。术后追踪观察3个月,染色组术后视力好于对照组,前房炎症反应、晶状体后囊混浊2组无统计学差异。染色组术后角膜、人工晶状体未见蓝染,未见术中及术后并发症。结论台盼蓝囊膜染色剂目前是一种安全可靠的技术,手术中可以看清前囊,使连续环形撕囊顺利进行,人工晶状体稳定的位于囊袋内,增加了白色白内障手术的成功率。     

白内障摘除联合后囊连续环形撕囊治疗先天性白内障

目的：观察先天性白内障摘除术中行后囊连续环形撕囊（PCCC）防治后发性白内障的疗效及可能出现的并发症。 方法：采用小切口先天性白内障单纯囊外摘除或联合人工晶状体植入术，对58例97眼先天性白内障患者进行后囊连续环形撕囊，使晶状体后囊中央形成约3～5mm的囊膜缺损区，行前部玻璃体切除术，以避免后发性白内障的发生。 结果：Ⅰ期植入人工晶状体50眼：术后1mo矫正视力≥0．6者18眼，0．5以下42眼；术后3mo矫正视力≥0．6者20眼，0．5以下46眼；术后6～12mo矫正视力≥0．6者21眼，0．5以下50眼。术后lmo第1次复查，无1眼发生后发性白内障，3mo周边部后囊膜浑浊40例，撕囊区清亮。6～12mo16眼发生新生膜，10眼少量玻璃体脱出于前房，玻璃体轻度浑浊，瞳孔不圆18眼，人工晶状体偏位10眼，无1眼发生视网膜脱离。 结论：后囊连续环形撕囊是一种经济、安全、高效的防止先天性白内障术后后发性白内障的手术方式，适用于不能配合激光治疗的儿童，但存在一定的复发率。     

非染色囊袋减压撕囊术500眼临床报告

目的:探讨寻找皮质膨胀或/和液化、囊袋饱满的白色白内障简单、成功有效的撕囊方法。方法:对500眼皮质膨胀或/和液化、囊袋饱满的白色白内障,采用非染色囊袋减压撕囊方法,充分利用粘弹物质,维持正常囊袋压力,固定已松动的晶状体核,保持前房视野清晰,在无红光反射背景下,依撕囊口边缘的反光为轨迹,控制撕囊的大小和方向,顺/逆时针方向,完成连续性环形撕囊、超声乳化及后房型人工晶状体植入。结果:四象限非染色囊袋减压撕囊464眼成功完成,20眼撕囊偏离轨道,借助囊膜剪切恢复撕囊轨迹后完成环形撕囊,12眼撕囊失败改为开罐式截囊,4眼撕囊裂向赤道部波及后囊膜,做相应处理。人工晶状体准确植入囊袋内490眼,人工晶状体植入睫状沟10眼(其中4眼行人工晶状体睫状沟缝线固定术)。随访0.5a,500眼人工晶状体位置均无偏心、移位及夹持。结论:非染色囊袋减压撕囊术是皮质膨胀或/和液化、囊袋饱满的白色白内障,特殊情况下简单有效的撕囊方法。     

儿童白内障Ⅰ期后囊连续环形撕囊临床观察

目的：探讨Ⅰ期后囊连续环形撕囊对儿童后发障的预防作用。方法：对42例（48只眼）在植入人工晶状体前施行Ⅰ期后囊连续环形撕囊，术后随访2个月至2年。结果：术后矫正视力≥0．5者有21只眼，占48．3％，随访期间有40只眼（83．3％）保持中央视轴区透明或基本透明。术后未发现严重并发症。结论：儿童白内障摘除联合人工晶状体植入术中施行Ⅰ期后囊连续环形撕囊，安全有效，在一定程度上可减少后囊混浊的发生。     

Ⅰ期后囊连续环形撕囊术在白内障术中应用

目的探讨自内障行晶状体超声乳化吸出人工晶状体植入术中Ⅰ期后囊连续环形撕囊术防治后囊浑浊的临床疗效及可行性。方法对192例（192眼）并发性白内障和术中发现后囊浑浊的老年性白内障,施行常规晶状体超声乳化吸出联合人工晶状体植入同时行后囊连续环形撕囊术。术后随访6～24月,观察视力、视轴区浑浊、人工晶状体位置、眼压、并发症等情况。结果术后矫正视力1．0以上的92眼（47．91％）、0．5～0．9者60眼（31．25％）、0．2—0．4者40眼（20．83％）。随访期间人工晶状体位置正、视轴区透明、眼压正常。并发症：4眼黄斑囊样水肿（2．08％）,无视网膜脱离等出现。结论Ⅰ期后囊连续环形撕囊术并发症少、方法简便、是防治后囊浑浊有效、经济的好方法,但需慎重选择手术适应症。     

水下连续环形撕囊在晶状体乳化术中的应用

目的探讨成熟期和过熟期白内障超声乳化手术中连续环形撕囊的方法并评价.方法对484例513眼核硬度Ⅲ级以上的白内障,分别行黏弹剂下常规连续环形撕囊和水下连续环形撕囊,并常规行晶状体乳化吸出和后房人工晶状体植入.结果黏弹剂下连续环形撕囊237眼,成功206眼,占86.96%;水下连续环形撕囊276眼,成功272眼,占98.55%.二者差异具有非常显著性意义(X2=14.07,P＜0.001).所有病例均顺利进行了后房人工晶状体植入,术后未发生严重并发症.结论对眼底红光反射不足或皮质液化的成熟或过熟期白内障采用水下连续环形撕囊的方法效果良好安全可行.     

巨大硬核小切口白内障手术中环形撕囊技术的改进

目的：分析巨大硬核白内障术中环形撕囊的直径大小,探讨环形撕囊技术的改进及评价环形撕囊联合放射状多点前囊口截开在巨大硬核白内障手术中应用的优点。
　　方法：对69例80眼巨大硬核白内障病例,成功施行前囊膜连续环形撕囊联合放射状多点前囊口截开,顺利娩核。结果：顺利完成手术78眼(98%),2眼因巨核挤压,发生后囊膜破裂或部分悬韧带断裂,术中双手法将核旋入前房,或用圈匙将核托入前房后娩出,清理瞳孔区玻璃体,Ⅱ期植入悬吊式人工晶状体。
　　结论：环形撕囊技术的改进即连续环形撕囊联合放射状多点前囊口截开在巨大硬核白内障术中应用是安全有效的。     

晶状体前囊吲哚青绿染色在白色白内障连续环形撕囊术中的应用

目的：探讨吲哚青绿染色品状体前囊膜来提高白色白内障连续环形撕囊成功率的技术。方法：家兔10只，用0．5％的吲哚青绿0．05ml染色晶状体前囊膜，分别于术后1天、1周处死5只后摘除眼球作病检。白色白内障80例(80眼)，随机分为实验组和对照组，实验组用0．5％的吲哚青绿0．05ml染色品状体前囊膜后进行连续环形撕囊，对照组用粘弹剂维持前房后直接进行连续环形撕囊。结果：所有兔眼术后均角膜透明，未见明显炎症反应，病理切片示所有标本未见炎症细胞浸润。临床试验中，两组患者均未发生明显术中和术后反应，实验组连续环形撕囊成功率为97．5％，对照组为80％，两组撕囊成功率之间比较，差异有显著性(χ^2＝4．51，P＝0．0338)。结论：白色白内障用0．5％的吲哚青绿染色后可提高连续环形撕囊的成功率，着色容易，安全，无明显副反应。     

Postoperative Changes Over Time in Size of Anterior Capsulorrhexis in Phacoemulsification/Aspiration

In the present study, we attempted to determine the extent to which an anterior capsulorrhexis carried out during cataract surgery contracts postoperatively. The size of the continuous curvilinear capsulorrhexis (CCC) was measured at the end of surgery and at the final follow-up examination in 52 eyes of 40 patients who underwent phacoemulsification/aspiration and implantation of an intraocular lens (IOL) with 6-mm optics. Images obtained by video during surgery and by slit-lamp microscopy were used to determine the CCC size with reference to the optics of the IOL. The average CCC size was 5.0 mm at the end of surgery; it contracted to 4.4 mm by the final postoperative examination. The contraction of the anterior capsule progressed rapidly in the first 50 days following surgery and then gradually thereafter. The extent of contraction was greater in older patients. The smaller the CCC size immediately after surgery, the more rapidly it contracted. The size of the capsulorrhexis contracted an average of 22% following cataract surgery. The contraction rate tended to be higher in older patients. The results suggest that the capsulorrhexis carried out in cataract surgery for elderly patients should be sufficiently large, but not larger than the optics size of the IOL.     

张力性空气泡下连续环形撕囊的临床报告

目的 评价张力性空气泡下连续环形撕囊术的效果。方法 对122例(122只眼)拟行现代白内障囊外摘除联合人工晶状体植入术的患者采用张力性空气泡填充前房后作连续环形撕囊。结果 122只眼中，成功完成连续环形撕囊者114只眼。结论 张力性空气泡下连续环形撕囊成功率高，并发症少，操作方便，值得推广。     

囊袋张力环在外伤性晶状体半脱位白内障超声乳化手术中的应用

目的:评价晶状体囊袋张力环(capsular tension ring,CTR)在外伤性晶状体半脱位白内障超声乳化手术中的应用效果。方法:对10例10眼外伤性白内障伴晶状体半脱位患者行白内障手术,术中连续环形撕囊后植入CTR,超声乳化术摘除白内障后,囊袋内植入后房型人工晶状体。结果:10眼术后随访3mo～2a,矫正视力0.3者2眼,0.4～0.7者6眼,>0.8者2眼。人工晶状体均基本正位,无明显倾斜偏位。仅1例患者于随访2a时出现后发性白内障,未见由CTR引起的并发症。结论:在外伤性晶状体半脱位白内障超声乳化手术中运用CTR,能提高手术安全性,减少手术并发症,是一种有效的白内障手术辅助工具。     

开窗术治疗白内障术后连续环形撕囊口纤维膜闭

目的：:探讨白内障术后连续环形撕囊（CCC）开口纤维膜闭行开窗术处理的初步临床效果。方法：:回顾性系列病例研究。对2011年9月至2018年9月在台州市眼科医院就诊的白内障术后前囊膜CCC开口完全纤维膜闭的患者15例（15眼）行纤维膜开窗切除手术,并对其纤维膜闭形成原因、手术方式和效果进行了探讨。结果：:所有术眼术后视...     

晶状体囊袋张力环在晶状体悬韧带断裂的白内障手术中的应用

目的　评价晶状体囊袋张力环 (capsulartensionring ,CTR)在晶状体悬韧带断裂的白内障手术中的应用。方法　对 11例 ( 11只眼 )外伤性晶状体悬韧带部分断裂的患者行白内障手术 ,术中连续环形撕囊后植入CTR ,然后行白内障摘除及后房型人工晶状体囊袋内植入。结果　 11只眼的人工晶状体均处于正位 ,无倾斜及明显偏位。术后 1个月矫正视力 0 4者 4只眼、0 5～ 0 8者 5只眼、>0 8者 2只眼。 1只眼因CTR直径过大 ,可见CTR 2个端口重叠。除白内障手术固有的并发症外 ,未见CTR引起其他并发症。结论　对晶状体悬韧带断裂的白内障患者术中应用CTR ,可利于术中操作 ,防止术后人工晶状体偏位的发生 ,并且有助于患者视力恢复 ;CRT是一种有效的白内障手术辅助工具。     

Intraoperative management of posterior capsule tears in phacoemulsification and intraocular lens implantation

OBJECTIVE: This paper presents the incidence, causes, and management of posterior capsule (PC) tears and their postoperative outcomes in a large series of eyes that underwent cataract removal and intraocular lens (IOL) implantation, operated on by one surgeon. DESIGN: Retrospective, noncomparative case series. PARTICIPANTS: Eighteen thousand four hundred seventy consecutive eyes (1992-1999) were reviewed with the assistance of electronic medical records for incidence of PC tears in patients seeking treatment at an outpatient cataract surgery clinic. INTERVENTION: Eyes in this series underwent continuous curvilinear capsulorrhexis (CCC), nucleofractis phacoemulsification, and IOL implantation under topical anesthesia. Different intraoperative surgical strategies such as posterior continuous curvilinear capsulorrhexis (PCCC) were used in the management of PC tears. MAIN OUTCOME MEASURES: Routine preoperative and postoperative visual and refractive outcomes were recorded, including incidence of lens capsule tears, IOL position, and postoperative complications. RESULTS: Posterior capsule tears occurred in 83 of 18,470 eyes, resulting in an overall incidence of 0.45%. Of these 83 eyes with PC tears, 49% received vitrectomy. Fifty-one of 83 PC tears (61.4%) were amenable to be converted to PCCC. Of these 51 procedures, 50 eyes had PC IOL in-the-bag fixation. One eye had PCCC with optic capture. There were no eyes with dropped nuclei or nuclear fragments requiring pars plana vitrectomy. Seventeen eyes (20.5%) had Neuhann anterior capsule rhexis fixation with the haptics placed in the sulcus and IOL securely in the bag. Ten eyes (12.1%) had the IOL placed in the sulcus, and 5 eyes (6.0%) required anterior chamber IOL fixation. None of the 83 PC tears resulted in clinically evident cystoid macular edema, retinal detachment, or endophthalmitis. CONCLUSIONS: With an intact CCC and with conversion of PC tears to PCCC, in-the-bag fixation of IOLs can be achieved in most eyes.     

Phacoemulsification in true exfoliation of the lens capsule: a case series

PURPOSE: We report five cases (seven eyes) of true exfoliation during an 18-month period. Of the two bilateral cases, the first was identified immediately before cataract surgery and the second spontaneously developed a split in the anterior capsule just before capsulorrhexis, mimicking a partial capsulorrhexis. In the three unilateral cases, true exfoliation was noted during the first examination. METHODS: Vision blue aided uneventful capsulorrhexis differentiating its edge from the true exfoliation edge, and in the first two cases, the anterior capsule was sent for histopathology and ultrasound of the fellow eye was requested. RESULTS: Ultrasound and histopathology demonstrated lamellar separation of the anterior portion of the lens capsule, confirming the diagnosis of true exfoliation. Cataract surgery by phacoemulsification was uneventful in all cases. CONCLUSION: True exfoliation of the lens capsule can masquerade as a partial capsulorrhexis and should be looked for before surgery and immediately before capsulorrhexis to avoid creating a partial thickness capsulorrhexis and its related surgical complications. No zonule weakness was appreciated in our cases. To our knowledge, the spontaneous occurrence of a curvilinear lamellar capsular dehiscence with a flap before capsulorrhexis has not been reported before. This series highlights that cataracts associated with true exfoliation of the lens capsule can be safely operated, with the help of vision blue, by routine phacoemulsification without having to convert to the extracapsular technique.     

小瞳孔下行手法小切口白内障摘除术的临床观察

目的:探讨手法小切口白内障摘除术在小瞳孔白内障中的应用。方法:对30例38眼小瞳孔白内障行手法小切口白内障摘除联合人工晶状体植入术,术中采用不同手术技巧扩张瞳孔,顺利娩出晶状体核。结果:术后1wk裸眼视力>0.5者16眼(42%),0.5≥视力≥0.3者19眼(50%),视力<0.3者3眼(8%),无明显并发症。结论:小瞳孔下行手法小切口白内障摘除手术是一种安全可靠的方法。