后极性白内障的手术体会

目的后极性白内障手术中晶体后囊膜破裂的几率非常高,我们根据晶体硬度分级,临床观察采用不同的手术方式治疗后极性白内障效果。方法本院2010年—2012年,观察17例后极性白内障手术患者。11例Ⅱ级核采用超声乳化手术,手中采用较小环形撕囊,运用粘弹剂水分层,去除周围皮质时运用较低固定参数,术后植入人工晶状体;6例Ⅲ级及以上核,均采用小切口手法,术中采用较大环形撕囊,同样采用水分层,旋转晶体核入前房,手动抽吸皮质,植入人工晶状体。结果术中观察1例Ⅱ级核和1例Ⅳ核白内障出现破裂,均植入晶体入睫状沟内。术后观察视力具有较大提高。未出现其他并发症。结论在后极性白内障手术过程中,根据不同晶体核分级,采用不同手术方式,注意细节,例如连续环形撕囊、超乳术中采用粘弹剂水分层等,则能够保证手术的安全有效。

Phacoemulsification and SICS in posterior polar cataract

Objective Posterior polar cataract are known to predispose to posterior capsule rupture. The incidence of posterior capsule rupture is higher. According the cataract nucleus, we used Phacnemnlsification and SICS to observe the result during the surgery. Methods We observed 17 cases of posterior polar cataract during 2010 - 2012. We used small CCC, viscodelineation,low fixed vacuum, IOL was implanted in the capsular bag in eleven softnuclear cataract（ 1I ） ; We used a little bigger CCC, viseodelineation and a gentle hydrodelineation ,taking the lens up to capsule using hooker, man- ual irrigation - aspiration, IOL was implanted in the capsular bag in six hardnucleus cataract （llI and above ）. Results We have two cases about posterior capsule rupture. One is phaco,another is SICS. IOL was implanted in sulcus over the capsu/orrhexis margin. The vision was approved and no complications in all cases. Conclusions According the nucleus, we use different surgery. We focus on the details, espically the CCC, viseodelineation, et al.