健康快车白内障超声乳化及人工晶状体植入1097例疗效观察

目的:评价健康快车广东茂名站白内障超声乳化联合人工晶状体植入术的疗效。方法:对1097例1097眼白内障超声乳化联合人工晶状体植入术的术后视力、眼压、术中术后并发症进行分析。结果:撕囊成功1078眼(98.27%),术后第1d视力>0.3者772眼(70.37%),术后第1d眼压在10～21mmHg者1043眼(95.08%),术中并发症主要为连续环形撕囊不成功19眼(1.73%),后囊破裂15眼(1.37%),误伤虹膜3眼(0.27%),虹膜脱出2眼(0.18%),术后并发症主要为角膜水肿362眼(33.00%)。结论:健康快车广东茂名站白内障手术脱盲率98.36%,脱残率70.37%,主要并发症为术后第1d角膜水肿。     

后囊连续环形撕囊治疗超声乳化术中后囊破裂的疗效观察

目的：：观察白内障超声乳化术中出现后囊破裂行后囊连续环形撕囊( PCCC)的临床效果。方法：对2013-03/10的38例38眼年龄相关性白内障患者行白内障超声乳化,术中出现后囊破裂的患者行后囊连续环形撕囊联合人工晶状体植入术;同期随机选择50例50眼年龄相关性白内障患者行白内障超声乳化联合人工晶状体植入术作为对照组,比较两组患者术后视力及其术后并发症情况,随访3 mo。结果：两组患者术后第1d视力、角膜水肿差异有统计学意义(P<0.05),术后3mo视力及角膜水肿差异无统计学意义(P>0.05);术后第1d眼压升高差异无统计学意义(P>0.05),术后3mo瞳孔及黄斑囊样水肿、视网膜脱离差异无统计学意义。结论：对于超声乳化术中发生后囊破裂的患者术中及时使用后囊连续环形撕除,能减少术后并发症发生,有效提高白内障术后效果。     

西藏地区白内障超声乳化联合人工晶状体植入术872例疗效观察

目的:分析西藏地区白内障的特点,并探讨健康快车西藏站白内障超声乳化联合人工晶状体植入术的疗效。方法:对西藏地区872例白内障的类型特点进行分析,并观察白内障超声乳化联合人工晶状体植入术的撕囊成功率,人工晶状体植入率,术中术后并发症及术后视力。结果:总共872眼,其中白色白内障705眼(80.8%);IV级核以上411眼(47.1%)。872眼术中撕囊成功率达98.9%,术后836眼第1d视力,<0.1者210眼(25.1%),0.1~0.25者210眼(25.1%),0.3~0.5者220眼(26.3%),0.6~0.8者140眼(16.7%),≥1.0者56眼(6.7%)。并发症:术中后囊破裂10眼(1.1%),术后角膜水肿124眼(14.2%)。结论:西藏地区白内障以过熟期白内障和硬核(IV级以上)白内障居多。白内障超声乳化联合人工晶状体植入术的疗效明显。     

超声乳化联合人工晶状体植入治疗过熟期白内障376例观察

目的 探讨超声乳化联合人工晶状体植入术治疗过熟期白内障的疗效.方法 对376例过熟期白内障施行超声乳化联合人工晶状体植入术,观察其撕囊成功率、人工晶状体囊袋内植入率、术中的并发症、术后视力、眼压等指标.结果 376眼中撕囊成功361眼(占96.01%),人工晶状体囊袋内植入367眼(占97.60%).术中后囊膜破裂4眼,部分悬韧带断裂3眼,乳化头损伤虹膜2眼.术后轻度角膜水肿36眼,虹膜部分后粘连2眼.术后第1天视力均有明显的提高,视力0.3以上有264眼(占70.21%),眼压正常.结论 超声乳化联合人工晶状体植入术治疗过熟期白内障的疗效良好(中国眼耳鼻喉科杂志,2007,7:99-100)     

台盼蓝染色技术在白内障超声乳化术中的应用

目的 观察在缺乏眼底红光反射的白内障超声乳化术中晶状体前囊膜台盼蓝染色技术的安全性及有效性。方法 对30例（30只眼）成熟期及过熟期白内障患者行超声乳化白内障吸除联合人工晶状体植入术,术中以0．1％的台盼蓝进行前囊膜染色,然后行连续环形撕囊术,观察术中情况,术后随访3个月,观察视力、眼压、角膜及房水情况。结果 30例白内障术中29例撕囊口边缘清晰可见．连续环形撕囊获得成功,手术顺利完成。1例术中囊膜染色不充分,囊口出现放射状撕裂,经补救撕囊．手术得以顺利进行。术后随访未发现与染色有关的眼部并发症。结论 在缺乏眼底红光反射的白内障超声乳化术中,以台盼蓝进行晶状体前囊膜染色后再行连续环形撕囊术是安全有效的方法。     

扭动模式联合旋转切削法用于撕囊失败眼的晶状体超声乳化术

目的 探讨扭动模式联合旋转切削法用于撕囊失败眼的晶状体超声乳化术的可行性、安全性和效果.方法 对白内障手术术中连续环行撕囊失败17例(17眼)改开罐式截囊,采用扭动模式联合旋转切削法行晶状体超声乳化联合人工晶状体植入术.术后随访3月,观察视力及并发症情况.结果 17例白内障均顺利完成晶状体超声乳化联合人工晶状体植入术.裸眼视力0.5～0.8者8眼,1.0及以上9眼;矫正视力1.0及以上13眼.并发症存注吸皮质时后囊破裂1眼,角膜中度水肿2眼,虹膜误吸损伤1眼.结论 对于连续环行撕囊失败者行扭动模式联合旋转切削法晶状体超声乳化是一种较为安全、有效的手术方法.     

台盼蓝囊膜染色剂在白内障连续环形撕囊手术中的应用

目的研究台盼蓝囊膜染色剂在治疗白色白内障中,是否有助于连续环形撕囊的顺利完成及白内障手术的顺利进行。方法79例(80眼),随机分为2组,染色组40例(41眼),对照组39例(39眼),染色组使用台盼蓝囊膜染色剂,术中观察及对比前囊膜染色情况、连续环性撕囊成功率、晶状体后囊破裂及人工晶状体囊袋内植入情况,术后视力、前房炎症反应、角膜、人工晶状体有无蓝染及后囊混浊情况。并与对照组进行统计学分析。结果染色组的术中染色均匀,连续环形撕囊及人工晶状体囊袋内植入率为97.7%,晶状体后囊破裂率为2.44%,与对照组进行统计学分析有显著差异。术后追踪观察3个月,染色组术后视力好于对照组,前房炎症反应、晶状体后囊混浊2组无统计学差异。染色组术后角膜、人工晶状体未见蓝染,未见术中及术后并发症。结论台盼蓝囊膜染色剂目前是一种安全可靠的技术,手术中可以看清前囊,使连续环形撕囊顺利进行,人工晶状体稳定的位于囊袋内,增加了白色白内障手术的成功率。     

辅助技术在治疗白内障合并角膜混浊手术中的应用

目的：评价在白内障手术中应用包括囊膜染色、虹膜拉钩、虹膜切除等辅助技术治疗白内障合并角膜混浊患眼的术后视觉效果,并分析手术安全性和有效性。

方法：回顾收集2014-01/2019-03在新疆军区总医院全军眼科中心接受白内障超声乳化合并人工晶状体植入术的白内障合并角膜混浊患者105例105眼,所有患者接受白内障超声乳化摘除并人工晶状体植入术。术中应用台盼蓝囊膜染色剂,并观察前囊膜染色情况,连续环形撕囊成功率,晶状体后囊破裂及人工晶状体囊袋内植入情况。并于术后1d,1wk,1、3mo对患者进行随访,观察术中撕囊成功率,术前、术后的最佳矫正视力(BCVA,LogMAR),术后并发症等。

结果：患者均接受白内障超声乳化吸除合并人工晶状体植入术。术中通过应用台盼蓝囊膜染色剂(台盼蓝)染色前囊膜辅助成功完成所有连续环形撕囊,并采取了包括应用虹膜拉钩及虹膜切开术等其他措施。将可折叠式人工晶状体植入105眼。术后追踪观察3mo,术眼术后BCVA为0.82±0.10,与术前BCVA(3.12±0.14)比较有差异(t=174.893,P<0.01)。

结论：白内障超声乳化摘除术能使白内障合并角膜混浊患者的视力得到安全有效的提高。辅助技术如囊膜染色、虹膜拉钩、虹膜切除等的应用,能有效降低白内障合并角膜混浊患者的白内障手术风险,提高手术安全性,增加手术成功率。     

改良亚甲蓝和台盼蓝前囊染色在白色白内障撕囊术中的临床应用对比

目的 探讨晶状体超声乳化术中改良亚甲蓝染色和台盼蓝染色对连续环形撕囊成功牢及对角膜内皮的影响.方法 67例(67眼)白色白内障(术中无红光反射者)随机分为3组进行前瞻性研究.改良亚甲蓝染色组25例,台盼蓝染色组24例,对照组(前囊不染色)18例.连续环形撕囊后行超声乳化及人工晶状体植入术.比较环形撕囊成功率、术中并发症、术后前房反应情况、视力、眼压、角膜内皮损失率及变异系数.结果 两种方法染色后撕囊成功率及人工晶状体囊袋内植入牢均为100.00%,无后囊破裂,与对照组相比差异有统计学意义;染色组术后视力高于对照组,但差异无统计学意义;3组术后眼压及角膜内皮损失率和变异系数筹异均无统计学意义.结论 改良亚甲监染色和台盼蓝染色均可明显提高连续环形撕囊成功率,降低超声乳化手术并发症,且无明显副作用,前者廉价易得,使用效果与台盼监相同.     

小瞳孔下囊膜染色双手连续环形撕囊法超声乳化手术疗效观察

目的 探讨小瞳孔白内障囊膜染色双手连续环形撕囊法超声乳化手术的疗效.方法 对31例(31眼)小瞳孔白内障患者,行囊膜染色后,以双手法一边拉开虹膜、瞳孔,一边连续环形撕囊,再行超声乳化人工晶状体植入术.术后5 d内,每天查视力,观察前房反应、瞳孔状态及人工晶状体状态.结果 术后除3眼因反应较重、视力恢复差外,其余28眼均获得了满意视力,术后视力范围0.15～0.80.3眼术后虹膜反应较重,前房闪辉(++);5眼出现轻度虹膜反应,前房闪辉(+);其余23眼仅部分有轻微前房反应.2眼瞳孔膜闭患者术后瞳孔居中,直径约2.5 mm,余29眼患者术后瞳孔位置及大小均与术前相当.结论 掌握好手术技巧,小瞳孔白内障囊膜染色双手连续环形撕囊法超声乳化手术同样能取得良好的临床效果.     

小瞳孔白内障超声乳化术的临床观察

目的:探讨小瞳孔下超声乳化白内障吸除及人工晶状体植入术的手术技巧和临床效果。方法:临床确诊的小瞳孔白内障患者35例43眼,采用黏弹剂钝性分离或瞳孔缘部虹膜拉开等方法扩大瞳孔,行环形撕囊、双手原位超声乳化白内障吸除及折叠式人工晶状体囊袋内植入手术。结果:术后随访5～12mo,视力≥0.5者26眼(60%),术后视力提高38眼(88%),所有患者的瞳孔均保持圆形或近圆形,部分患者瞳孔直径较术前变大,无人工晶状体偏位。手术并发症主要有角膜水肿、前房纤维素性渗出或后囊膜破裂等。结论:小瞳孔下白内障的超声乳化手术复杂,熟练的掌握手术技巧及合理的手术时机,同样可以取得良好的手术效果。     

Trypan blue as an adjunct for safe phacoemulsification in eyes with white cataract

PURPOSE: To assess the feasibility, risks, and postoperative outcomes of phacoemulsification with posterior chamber intraocular lens (PC IOL) implantation in cases of white cataract with the use of trypan blue as an adjunct for performing continuous curvilinear capsulorhexis (CCC) in the absence of a red reflex. SETTING: Dr. Agarwal's Eye Hospital, Chennai, India. METHODS: This prospective study comprised 52 eyes of 52 patients with white cataract that had phacoemulsification through a clear corneal temporal incision with PC IOL implantation. In all the cases, trypan blue was used under air to stain the anterior lens capsule and the karate-chop technique was used to emulsify the nucleus. The mean follow-up was 192.2 days. RESULTS: Trypan blue adequately stained the anterior lens capsule in all cases. The CCC was completed uneventfully in 96.15% eyes; 3.85% of cases had to be converted to a conventional extraction technique because of the loss of the CCC. The mean phacoemulsification time was 2.2 minutes. Intraocular complications included incomplete capsulorhexis (3.85%) and pupillary miosis (3.80%). Postoperatively, 3 eyes (5.77%) had corneal edema (striate keratopathy) and 1 eye (1.9%) had fibrin in the anterior chamber. Five eyes (9.61%) had more than 2+ cells and flare at 2 weeks. All responded well to intensive topical and subconjunctival steroids. There were no cases of endophthalmitis. The mean central endothelial cell loss, measured in 37 eyes, was 8.5%. Of the 4 eyes (7.69%) that had increased intraocular pressure (IOP) postoperatively, all responded well to medications and the IOP was normal by the second postoperative week. Fifty eyes (96.16%) had a final best corrected visual acuity of 20/30 or better. In 2 cases, the final visual acuity was worse than 20/200 because of preexisting posterior segment pathology. CONCLUSION: Phacoemulsification using trypan blue was safe and effective in managing white cataract and had a high success rate.     

Comparing the efficacy and safety of phacoemulsification in white mature and other types of senile cataracts

Aim: To compare the intraoperative difficulty and postoperative outcome in patients who have white mature cataract in one eye and other types of senile cataract in the other eye undergoing clear corneal phacoemulsification and foldable intraocular lens implantation. METHODS: 82 patients who had white mature cataract in one eye, posterior subcapsular, cortical, nuclear, or mixed type cataract in the other eye were enrolled in this prospective study. Postoperative outcomes, intraoperative difficulties related to capsulorhexis, and phacoemulsification were analysed between the two groups of eyes. Postoperative examinations were done at 1 day, 1 week, 1 and 3 months. RESULTS: Postoperative visual acuity, central corneal thickness, intraocular pressure, and rate of posterior capsule rupture were not significantly different between the two group of eyes (p>0.05). Mean effective phaco time, frequency of postoperative corneal oedema and posterior capsular plaque were found to be significantly higher in the mature cataract group (p<0.05). CONCLUSIONS: A one stage, 5 mm continuous capsulorhexis was achieved using trypan blue and generous amounts of retentive viscoelastic agent in eyes with white mature cataract. Intraoperative difficulties and postoperative outcome of clear corneal incision phacoemulsification surgery and foldable intraocular lens implantation were similar in white mature and other types of senile cataract. Topical anaesthesia in phacoemulsification of eyes with white mature cataract is safe and well tolerated.     

电子撕囊针在白色白内障手术中的应用

目的　评估电子撕囊针在白色白内障手术中应用的安全性和有效性。方法　３０例（３０眼）白色白内障患者随机分为常规撕囊组和电子撕囊组,各１５眼,均行白内障超声乳化联合人工晶状体植入术。常规撕囊组用传统撕囊镊撕囊,电子撕囊组用电子撕囊针撕囊。观察两组撕囊状况及人工晶状体植入情况。结果　两组所有患者均顺利完成白内障超声乳化联合人工晶状体植入术。除常规撕囊组１眼行人工晶状体睫状沟植入外,其余患者均囊袋内植入。常规撕囊组撕囊优良率只有２０％,失败率达６０％,而电子撕囊组撕囊优良率达１００％,两组差异有统计学意义（χ２＝１４．５２,Ｐ＜０．０１）。术后１周２组矫正视力和角膜内皮细胞计数差异均无统计学意义（均为Ｐ＞０．０５）。结论　白色白内障超声乳化术中使用电子撕囊针撕囊安全有效。     

超声乳化人工晶状体植入治疗葡萄膜炎并发性白内障

目的：探讨白内障超声乳化联合人工晶状体植入手术治疗葡萄膜炎并发性白内障的手术疗效。
　　方法：本研究采用系统性回顾研究,选取2015-01/12在南京军区南京总医院眼科诊断为葡萄膜炎并发性白内障的患者57例57眼,所有患者均行白内障超声乳化联合人工晶状体植入术,对患者的术中并发症,术后效果及并发症情况进行回顾分析。对手术前后视力进行非参数Wilcoxon检验。
　　结果：所选患者超声乳化术中发生虹膜出血21眼(37%),后囊膜破裂4眼(7%),人工晶状体无法植入4眼(7%),术后裸眼视力获得不同程度提高,术前裸眼视力≥0.1者8眼(14%),术后3mo裸眼视力≥0.1者42眼(74%),差异有统计学意义(Z=23.42,P<0.001)。术后1 d发生角膜水肿17眼(30%)、葡萄膜炎2眼(4%)、高眼压1眼(2%),术后1wk发生角膜水肿3眼(5%),术后1mo发生葡萄膜炎1眼(2%),术后3mo发生角膜水肿1眼(2%)、葡萄膜炎2眼(4%)、高眼压1眼(2%)、后发性白内障3眼(5%)。
　　结论：白内障超声乳化联合人工晶状体植入手术治疗葡萄膜炎并发性白内障,术后效果好,并发症少。     

超声乳化人工晶状体植入术影响视力因素分析

目的　分析超声乳化吸出人工晶状体植入影响视力因素。方法　对 196例 2 19眼白内障超声乳化吸出人工晶状体植入术影响视力因素进行分析。结果　术后 1月 ,矫正视力 :<0 .5者 5 6眼 (2 5 6% ) ,0 .5～ 0 .9者 94眼 (4 2 .9% ) ,≥ 1 0者69眼 (3 1 5 % )。影响视力的主要因素 :术后并发症如角膜水肿及失代偿、后囊浑浊、葡萄膜炎、人工晶状体偏位及术前合并眼病。结论　白内障超声乳化吸出人工晶状体植入术中减少术中术后并发症 ,可提高术后视力     

Trypan blue assisted phacoemulsification in corneal opacities

AIM: To evaluate the efficacy of trypan blue for enhancing visualisation during phacoemulsification and foldable lens implantation in cases of cataract with corneal opacities. METHODS: 11 eyes of 11 patients with nebulomacular corneal opacities involving the visual axis with partially and visually debilitating cataract underwent trypan blue assisted phacoemulsification with foldable intraocular lens implantation. The patients were followed at the first day, first week, first month, and third month postoperatively. Completion of capsulorhexis, phacoemulsification with foldable lens implantation, and postoperative best corrected visual acuity were measured. RESULTS: The dye improved visualisation of the anterior capsule and a complete capsulorhexis could be performed successfully in all eyes. In all but one eye phacoemulsification was accomplished successfully. In one eye with Fuchs' dystrophy penetrating keratoplasty was performed later. Visual acuity was < or = 6/60 preoperatively in all eyes and improved to > or = 6/24 in eight eyes postoperatively. CONCLUSION: Trypan blue assisted phacoemulsification may be performed in selected cases of corneal haze/opacification with cataract. It provides acceptable visual outcome in cases awaiting penetrating keratoplasty or in cases where it is not feasible or promising.     

PCCC处理超声乳化白内障术中后囊膜破裂

目的:探讨后囊膜连续环形撕囊(PCCC)在白内障手术中的意义。方法:回顾性研究分析2003-01/2010-12在我院行白内障超声乳化手术、术中后囊膜破裂非计划行后囊膜连续环形撕囊的病例,定期观察最佳矫正视力、角膜内皮计数、眼压、角膜水肿情况、前房Tyndall’s征、瞳孔及人工晶状体位置情况。结果:术后1mo,PCCC组与未行PCCC组的最佳矫正视力0.8以上的差异有统计学意义;术后1mo,PCCC组与未行PCCC组的角膜内皮计数、眼压、角膜水肿情况、前房Tyndall’s征的差异均无统计学意义。结论:后囊膜破裂后在可行PCCC的病例中可以更有效地减少术后并发症,使患者得到更稳定舒适的视觉效果。     

小瞳孔白内障的超声乳化及折叠式人工晶状体植入术

目的探讨小瞳孔白内障的超声乳化及折叠式人工晶状体的手术技巧和临床效果。方法临床确诊的小瞳孔白内障患者46例54眼,经透明角膜隧道切口,采用钝性分离的方法扩大瞳孔,行环行撕囊、双手原位超声乳化及折叠式人工晶体囊袋内植入手术。结果术后随访5～12月,术后视力提高46眼占85.19%,视力≥0.5者34眼占62.96%,所有患者的瞳孔保持生理性圆形或是近圆形。手术并发症主要有角膜水肿、前房纤维素性渗出、后囊破裂。结论掌握合理的手术技巧,小瞳孔白内障的超声乳化术同样可以取得良好的手术效果。