表面麻醉下自闭式小切口非超声乳化白内障摘除人工晶状体植入术

目的:探讨表面麻醉下自闭式小切口非超声乳化白内障人工晶状体植入术的临床应用,手术方法、过程及效果。方法:对1016例1016眼行表面麻醉下自闭式小切口非超声乳化摘除术的视力,术中、术后并发症及其防治。术中实行表面麻醉,自闭式巩膜隧道小切口,连续环形撕囊,手法挽核,植入人工晶状体。结果:1016例实行表面麻醉患者均能耐受,其中有891眼(87.7%)顺利完成连续环形撕囊,125眼(12.3%)因各种原因改为开罐式截囊,术中12眼在抽吸皮质时后囊撕裂。自闭性小切口923眼(90.8%)。19眼术后次日发生轻度角膜水肿。1016眼术后3d视力≥0.5者713例,占70.2%。无明显并发症。结论:表面麻醉下自闭式小切口非超声乳化白内障摘除术可获得与超声乳化术相近的效果,而且对Ⅳ和Ⅴ级核白内障更安全。

Non-phacoemulsification small incision extra-capsular cataract extraction combined with intraocular lens implantation under topi-cal anesthesia

·AIM:To investigate the clinical application,surgical technique,process and effect of non-phacoemulsification small incision extracapsular cataract extraction(ECCE)combined with intraocular lens(IOL)implantation under surface anesthesia..METHODS:A total of 1 016 cases(1 016 eyes)under-went non-phacoemulsification cataract surgery.During the course of operation,scleral tunnel-like small incision was made under surface anesthesia,and continuous circular capsulorhexis was performed without suturing incisions.Patients’ visual acuity,intra-and post-operative complica-tions were discussed..RESULTS:All of the patients undergoing topical anesthesia could tolerate the surgery.Continuous circular capsulorhexis was successfully accomplished in 891 eyes(87.7%);for various reasons,anterior capsule was opened in 125 eyes(12.3%);posterior capsule was torn when cortex was aspirated in 12 eyes;small incision was made without suture in 923 eyes(90.8%)and the anterior chamber was watertight;mild corneal edema occurred in 19 eyes on the next day after the operation.At 3 days postoperatively,713 cases(70.2%)had the visual acuity ≥0.5.No obvious complications were observed..CONCLUSION:The effect of non-phacoemulsification small incision ECCE combined with IOL implantation under surface anesthesia was similar to that of phacoemulsifi-cation cataract surgery.Moreover,it was safer for cata-ract with IV or V grade nucleus..