颞侧透明角膜隧道切口的超声乳化白内障吸出及折叠式人工晶体植入术

目的探讨经颞侧透明角膜隧道切口的超声乳化白内障吸出及折叠式人工晶体植入术的效果及其优、缺点。方法用钻石刀在颞侧角膜周边血管弓中央的透明角膜上，做一深０．３０ｍｍ、宽１．７５ｍｍ和内口长３．２０ｍｍ、外口长３．５０ｍｍ的梯形角膜隧道切口，对８１２例（８４５只眼）老年性白内障施行超声乳化白内障吸出及折叠式人工晶体植入术，术后观察视力、角膜地形图、角膜散光及角膜内皮的变化。结果术后第１天和１个月，６１．３０％和７９．０５％的术眼裸眼视力达到或超过０．５，术后早期切口附近角膜变平，视轴中央角膜散光有轻微变化，角膜内皮细胞丢失率为８．２３％。并发症主要有切口热灼伤（０．４０％）、术中后囊膜破裂（１．０７％）、晶体脱位（０．１２％）、眼内炎（０．１２％）和囊样黄斑水肿（０．２４％）。结论经颞侧透明角膜隧道切口施行超声乳化白内障吸出及折叠式人工晶体植入术，操作便利，手术疗效良好、稳定

Phacoemulsification and foldable lens implantation through a temporal clear corneal tunnel incision

Objective To investigate the therapeutic effects, advantages and disadvantages of phacoemulsification and foldable lens implantation through a temporal clear corneal incision. Methods Eight hundreds and twelve patients (845 eyes) underwent phacoemulsification and foldable lens implantation through a temporal clear corneal tunnel incision which has a groove of 0.30 mm deep, a tunnel length of 1.75 mm, an internal opening of 3.20 mm and an external opening of 3.50 mm. The postoperative uncorrected visual acuity, the changes of corneal topography, astigmatism and endothelia were observed. Results The proportions of uncorrected visual acuity of 0.5 or better were 61.30% and 79.05% respectively at one day and a month after the operation. Postoperatively, topographical changes displayed temporal flattening near the incision in the early stage. The change of central corneal astigmatism was mild. Endothelial cell loss was 8.23%. The complications included burn of the incision (0.40%), tear of the posterior capsule (1.07%), subluxation of the lens (0.12%), endophthalmitis (0.12%) and cystoid macular edema (0.24%). Conclusion The phacoemulsification and foldable lens implantation through a temporal clear corneal incision is convenient and effective.