小瞳孔状态下白内障超声乳化术

目的　探讨小瞳孔状态下白内障超声乳化手术的技巧及注意事项。方法　观察 3年来的 86例 (98眼 )小瞳孔超声乳化手术情况。手术方法 :表面麻醉 ,需分离虹膜者加前房内麻醉 ,巩膜隧道切口 ,左手用虹膜钩拉开虹膜 ,右手做环形撕囊 ,超声乳化吸出 ,植入人工晶状体。结果　 98眼中术后瞳孔保持原状 88眼 ,对光反应恢复正常 4眼 ,瞳孔变形 6眼。术后 1周裸眼视力 >0 .5 46眼 (46 9% ) ,>0 .1 89眼 (90 .8% )。影响视力主要原因为视网膜及玻璃体的病变。后囊破裂 6眼 ,均植入人工晶状体 ;瞳孔损伤 5眼 ;角膜水肿 6眼 ,术后 5天消退。结论　该方法不需切开虹膜 ,损伤小 ,术后视力、瞳孔恢复好 ,但要求手术者有较好的超声乳化手术基础

Phacoemulsification under small pupil

Objective To search the technique of phacoemulsification under the state of small pupil and some points that should be paid attention to.Methods 86 cases (98 eyes) of phacoemulsification in our hospital in recent three years were observed.The operation methods included surface anaesthesia (anterior chamber anaesthesia was used when iris seperation was needed),scleral tunnel incision,iris hook was used to burst through iris by left hand and continous curvilinear capsulorhexis,emulsification and aspiration by right hand.At last implantion of intraocular lens.Results 88 eyes preserved previous condition, 4 eyes recovered to ordinary light refection,6 eyes appeared distortion of pupil.All of those cases had been implanted IOL.One week after operation,46 eyes(46.9%)had uncorrected vision >0.5,89 eyes (90.8%)>0.1.The main factors that influenced the vision were diseases of vitrous and retina.There was no serious complication.6 eyes appeared posterior capsule rupture.5 eyes had damnification of pupil,6 eyes corneal edema,but disappeared five days after operation.Conclusion It is unnecessary to cut iris using this sort of method of phacoemulsification and had some advantages such as less damnification,operating conveniently.After operation,vision and pupil recover well.Except that,this method demands surgeons with better experience of phacoemulsification.