白内障小切口非超声乳化手术临床观察

目的探讨白内障小切口非超声乳化手术的临床应用特点及治疗效果。方法 59例（60只眼）白内障患者行巩膜隧道小切口下非超声乳化白内障囊外摘除及人工晶状体植入术,观察手术并发症及术后视力恢复情况。结果术后1个月,视力≥0.6者46只眼（76.7%）,≥0.3者55只眼（91.7%）,术中后囊膜破裂2只眼,术后角膜水肿21只眼。结论白内障小切口非超声乳化手术不需要特殊的手术设备,手术操作简单,安全性高,术后视力恢复快,值得临床推广应用。     

小切口非超声乳化白内障摘除术与超声乳化吸除术的疗效观察

目的通过比较小切口非超声乳化白内障摘除术与超声乳化白内障吸除术，探讨更适合在基层医院以及医疗扶贫行动中推广应用的手术方法。方法抽取200例（200只眼）白内障患者，其中小切口非超声乳化手术118例（118只眼），超声乳化吸除术82例（82只眼）。对比观察两种手术术后视力恢复情况、术中术后的并发症，以及两种手术方法的手术成本。结果小切口非超声乳化白内障摘除术及超声乳化白内障吸除术在术后视力、术中术后并发症和患者满意度在远期均无显著差异，而手术成本小切口非超声乳化术明显低于超声乳化吸除术。结论小切口非超声乳化白内障摘除术更适合在基层医院以及医疗扶贫行动中推广应用。     

门诊白内障患者表面麻醉下透明角膜切口的超声乳化术

目的观察门诊白内障患者表麻下透明角膜切口超声乳化术的临床效果。方法临床确诊的各种白内障门诊患者143例(158只眼),在表面麻醉下经透明角膜切口,行白内障超声乳化吸除及折叠式人工晶状体植入手术。结果所有患者均能耐受手术,未发生麻醉并发症。术后第1天视力≥0.5者129只眼,占82.3%;术后1周视力≥0.5者149只眼,占94.2%。手术并发症主要有:角膜水肿、后囊破裂及结膜水肿。结论在门诊开展表麻下透明角膜切口白内障超声乳化术安全、可靠,比其它麻醉方式并发症少,术后视力恢复快,患者乐于接受。     

小切口非超声乳化在贫闲白内障患者中的应用

目的评价小切口非超声乳化白内障摘出术在贫困白内障患者复明手术中应用的效果。方法对100例（100眼）贫困白内障患者施行小切口非超声乳化术,观察患者术中、术后并发症,术后视力恢复情况及患者满意度。结果术中发生后囊破裂9眼,其中6眼为白内障过熟期,3眼为高血压患者。术后角膜水肿13眼,无严重并发症。术后3d裸眼视力0．5以上者78眼,0．3～0．5者13眼,0．1～0．25者6眼,0．1以下者3眼。患者满意度高。结论小切口非超声乳化术适合批量白内障复明工程。贫困白内障患者宜抓紧及时救治。     

微切口超声乳化人工晶状体植入治疗葡萄膜炎并发白内障

目的:探索微切口超声乳化人工晶状体植入术治疗葡萄膜炎并发白内障的临床疗效和安全性。方法:对32例40眼葡萄膜炎并发白内障的患者施行微切口超声乳化人工晶状体植入术,术中慎重处理小瞳孔和虹膜后粘连,尽量避免刺激虹膜,术后回顾性分析术后患者视力、并发症。结果:随访1～13(平均7.6)mo,40眼术后瞳孔基本圆,视力均有不同程度提高,术中3眼后囊膜破裂,2眼虹膜渗血。术后并发症主要有角膜水肿、瞳孔后粘连、葡萄膜炎复发,经相应处理后均已消失。结论:微切口超声乳化人工晶状体植入术是治疗葡萄膜炎并发白内障的安全有效的方法之一,它使角巩膜切口更小,术中损伤小,不伤及虹膜,术后前段反应轻,视力恢复好。     

小切口非超声乳化白内障摘除术疗效观察

目的观察小切口非超声乳化白内障摘除术的临床效果。方法对44例(49只眼)白内障患者行小切口非超声乳化白内障囊外摘除联合人工晶状体植入术。结果术后第1天视力≥0.5者30只眼(62.12%)眼,≥0.8者10只眼(20.4%),术后1周视力≥0.5者35只眼(71.42%),≥1.0者13只眼(26.5%)。术后第1天角膜水肿者8只眼(16.32%)。结论小切口非超声乳化白内障摘除术技术操作简单,易于掌握,疗效较好,值得推广应用。     

小切口白内障囊外摘出与超声乳化白内障摘出效果比较

目的 比较小切口白内障囊外摘出人工晶状体植入术与超声乳化白内障吸出硬质人工晶状体植入术两种方法的临床效果。方法 分别对140只眼小切口非超声乳化白内障囊外摘出术及154只眼超声乳化硬质人工晶状体植入术的术后视力、角膜内皮丢失率，术中、术后并发症进行比较。结果 小切口非乳化组1周后视力＞0．5者115只眼(82．2％)，＜0．4者25只眼(17．8％)。超声乳化组＞0．5者128只眼(83．1％)，＜0．4者26只眼(16．9％)。角膜内皮丢失率，小切口非超声乳化组13．2％，超声乳化组12．8％。术后角膜内皮水肿：小切口非乳化组11只眼(7．86％)，超声乳化组10只眼(6．49％)。结论 小切口非超声乳化白内障摘出与超声乳化硬质人工晶状体植入术疗效相似，前者简便、易行、经济，适宜于基层医院开展。     

非超声乳化小切口与超声乳化吸除手术白内障临床对比分析

目的 探讨非超声乳化小切口白内障囊外摘除联合人工晶状体植入术与超声乳化白内障吸除联合人工晶状体植入术术后效果的差异.方法 对104例(106只眼)白内障患者施行巩膜隧道式小切口白内障摘除联合后房型人工晶状体植入术,91例(104只眼)施行白内障超声乳化联合人工晶状体植入术.结果 非超声乳化组术后第1天裸眼视力等于或大于0.8者或以上者占54.72%,术后一周裸眼视力大于0.8者或以上者占83.02%,角膜水肿占54.72%,虹膜损伤占34.91%;而超声乳化组术后裸眼视力术后第一天等于或大于0.8者占74.04%,术后一周裸眼视力等于或大于0.8者占97.11%,角膜水肿20.19%,虹膜损伤7.69%.两组经方差分析差异具有统计学意义(P<0.01).结论 超声乳化白内障吸除术较非超声乳化小切口白内障摘除术具有术后组织反应轻,组织损伤小及术后视力恢复快等优点.     

小切口水压法娩核白内障非超声乳化摘除术临床分析

目的探讨小切口水压法娩核白内障非超声乳化摘除术的疗效及价值。方法2005年1月~12月对我院白内障患者204只眼随机行超声乳化手术(35只眼)和小切口水压法娩核非超声乳化摘除术(169只眼),观察术后视觉质量、手术成本及患者满意度。结果小切口水压法娩核非超声乳化术组手术成本及住院费用明显低于超声乳化术组,且术后视觉质量与超声乳化术组无显著差异,不影响患者对视力提高的满意度。结论小切口水压法娩核白内障非超声乳化摘除术尤其适合在基层医院开展,值得推广应用。     

超声乳化与小切口非乳化白内障摘出视力比较

目的　观察比较晶状体超声乳化吸出术与小切口非超声乳化白内障囊外摘出术的术后视力。方法　将老年性白内障患者随机分 2组 ,A组行晶状体超声乳化吸出术 ,B组行小切口非超声乳化白内障囊外摘出术 ,观察术后第 1天、3 0天的视力。结果　共观察 2 3 0例 ,2 3 0眼。A组 13 4眼 ,B组 96眼。两组术后视力差异无显著意义 (Uc =1 0 68,P >0 0 5 )。结论　超声乳化吸出术与小切口非超声乳化白内障囊外摘出术的术后视力比较差异无显著意义     

白内障晶体半脱位超声乳化术技术探讨

目的：探讨白内障晶体半脱位超声乳化的手术技术要点及手术技巧。方法：对17例17眼白内障晶体半脱位的患者行白内障超声乳化吸出联合后房型囊袋内人工晶体植入手术,并对手术技术的要点技巧进行了研究。结果：术后14例前房反应与正常超声乳化相同;30天视力大于或等于0．8者10例,大于或等于0．5者13例;矫正视力1．0者11例,大于或等于0．5者15例;人工晶体位于中央者13例;人工晶体偏心4例;术后继发青光眼3例。结论：对白内障晶状体半脱位行小切口超声乳化吸出联合囊袋内后房型人工晶体植入手术,术后并发症少,视力恢复好,为此类病人的最佳手术方法。     

Phacoemulsification with a blow-out fracture in the early postoperative period

An 81-year-old woman had uneventful phacoemulsification through a self-sealing clear corneal wound. The postoperative course was complicated by a fall 10 days after surgery during which she hit her face on the carpet with sufficient force to cause an orbital floor blow-out fracture. Despite the blow, the corneal wound remained intact. As well as the advantage of rapid visual rehabilitation, sutureless corneal wounds provide a secure incision that has the ability to avoid leakage and iris prolapse despite great forces that may be applied to them.     

白内障超声乳化及人工晶状体植入联合小梁切除术临床观察

目的 评价白内障超声乳化及折叠式人工晶状体植入联合小梁切除术的疗效。方法 对１６例９１８眼）青光眼合并白内障施行白内障旋转切削亏声乳化摘出及折叠式人工晶状体植 梁切除术。结果 １６例术后３月眼压均控制（７２．２％）。结论 该术式具有视力恢复较好,降眼压效果确实,并发症少的优点。     

高度近視眼合并白内障超聲乳化摘除術

目的觀察高度近視合并白内障超聲乳化摘除及人工晶狀體植入術的療效.方法對72例(79眼)高度近視白内障患者術前檢查眼軸長,計算人工晶狀體屈光度,經鞏膜隧道切口行超聲乳化摘除及人工晶狀體植入術,對術后視力及并發症進行觀察.結果 79眼術后視力不同程度提高,術后1月視力≥0.5者48眼,＜0.3者13眼,高度近視合并眼底病變是白内障術后視力不佳的原因.結論白内障超聲乳化摘除聯合人工晶狀體植入術是高度近視合并白内障較理想的手術方式,及早抓住手術時機,可以减少手術并發症的發生,獲得良好的手術效果.     

Clear corneal incision leakage after phacoemulsification––detection using povidone iodine 5%

The purpose of this work was to study the incidence of clear corneal wound leakage at the conclusion of standard co-axial phacoemulsification in a prospective observational series of 100 consecutive cataract cases in a single surgeon’s institutional practice. At the conclusion of standard co-axial phacoemulsification using a 2.75 mm temporal single plane clear corneal incision with a 1 mm clear corneal side-port incision, the wounds were hydrated and checked for water-tightness. Povidone iodine 5% (P-I) was then evenly dripped over the cornea and the wounds were inspected visually. Any leakage of aqueous observed was recorded. The amount of leakage was graded as small or large from each wound. Leaky wounds were further hydrated and retested with P-I until sealed. Wound integrity was reassessed on the first postoperative day by use of fluorescein. Of the 100 cases, wound leakage was observed for 31 eyes (31%)—ten main incisions, nineteen side-port incisions, and both incisions in two cases. Wound leakage was easily detected as a ribbon of clear fluid streaming from the incision amid a pool of brown solution. Povidone iodine was not observed within the tract in any incision. All wound leakage was small except for one from the main incision and two from the side-port incision. None of the eyes developed wound leakage the day after surgery and none developed endophthalmitis. In conclusion, leakage from clear corneal incisions at the conclusion of phacoemulsification occurs in almost a third of cases, predominantly from the side incision. It is easily detected by use of the P-I test.     

抗青光眼滤过术后患者白内障超声乳化吸除及人工晶状体植入术

目的：探讨抗青光眼滤过术后白内障患者进行白内障超声乳化吸除及人工晶状体植入术的手术切口选择和临床效果。方法：32例（41只眼）青光眼滤过术后的白内障患者,采用上方透明角膜隧道切口和避开滤过泡的巩膜隧道切口行白内障超声乳化吸除,植入折叠式人工晶状体24只眼,硬性人工晶状体17只眼。结果：全部白内障术后病例视力有不同程度的提高,视力≥0．5者达75．6％。采用透明角膜隧道切口和巩膜隧道切口术后患者的眼压和滤过泡改变无差异性,术后随访平均5个月,平均眼压较术前增加1．59mmHg(1mmHg=0.133kPa),差异无显著性。结论：对抗青光眼滤过术后白内障患者,采用透明角膜和巩膜隧道切口行白内障超声乳化吸除及人工晶状体植入术,可提高视力,同时可保持原有的滤过功能。     

白内障超声乳化术后早期浅前房原因及处理

目的：探讨防止超声乳化白内障摘除术后浅前房所引起的眼部损害的方法。方法：对１８例超声乳化白内障摘除术后浅前房的病例进行观察,分析其原因及处理方法,其中１７例为老年性白内障,１例为先天性白内障,术中通过颞侧透明角膜隧道切口行超声乳化白内障摘除及折叠式人工晶体植入术,观察术后前房的深浅、视力及眼压变化。结果：１８例浅前房中,９例为切口漏水。８例为瞳孔阻滞,１例为迟发性脉络膜上腔出血,切口漏水组须再次手     

The clear corneal tongue: a mechanism for wound incompetence after phacoemulsification

PURPOSE: To describe a mechanism for wound incompetence after phacoemulsification with corneal incisions resulting in early postoperative wound leakage. DESIGN: Observational case series. METHODS: Three patients who had uneventful phacoemulsification through a clear corneal incision were identified because of a postoperative wound leak. A corneal tongue, consisting of an everted triangular flap of posterior corneal stroma, the Descemet membrane, and endothelium, was observed in the wounds of all cases. RESULTS: One wound leak resolved after pressure patching. The other two necessitated wound revisions. None of the patients developed endophthalmitis. CONCLUSIONS: In phacoemulsification with corneal incisions, an everted flap of posterior corneal tissue, a corneal tongue, may prevent normal anatomical apposition of the surgical wound edges leading to potential wound incompetence. This event may increase the risk of endophthalmitis after clear corneal phacoemulsification.     

梯形小切口手法碎核人工晶状体植入术

目的 探讨梯形小切口及两种手法碎核方法在非超声乳化白内障摘出术中的应用。方法 用梯形小切口及穿刺碎核法和圈套碎核法施行白内障手术57例78眼。结果 术后裸眼视力≥0.5者占60.26%,矫正视力≥0.5者占97.44%,后囊破裂3例。结论 梯形小切口联合手法碎核技术治疗白内障,切口小、娩核容易、角膜损伤小,视力恢复快。     

Acrysof折叠式人工晶状体植入术后观察

目的：评价白内障手术方式及Acrysof人工晶状体植入手术的疗效。方法：对3组61例（64眼）老年性白内障分别采用3.2-6.5mm巩膜隧道和孤长12mm巩膜阶梯切口，分别施行白内障超声乳化摘出联合折叠式人工晶状体植入术，超声乳化摘出联合一体型人工晶状体植入术和囊外摘出联合一体型人工晶状体植入术。结果：术后5天3组平均裸眼视力分别为0.83,0.75和0.51，达到1.0以上视力比例分别为53.33%,26.09%和7.69%,前者和后两者比较，差异均有显著性（q检验，P＜0.01)。结论：采用小切口折叠式人工晶状体植入术具有术后视力早期恢复的优点。