后极性白内障的超声乳化手术治疗

目的:探讨后极性白内障的临床特点及超声乳化手术的手术技巧。方法:连续收集2009-10/2011-03在本院诊治的后极性白内障患者12例17眼,所有病例均接受详尽的病史采集,以及视力、裂隙灯显微镜检查,B型超声波及间接检眼镜检查,所有患眼在球周浸润麻醉下行超声乳化白内障摘除及折叠人工晶状体植入,总结手术技巧、术前术后视力及术中并发症。结果:所有患眼均植入折叠人工晶状体。术中11眼后囊膜完整透明,2眼后囊膜破裂,其中1眼发生在分核时,另1眼发生在核周壳吸除时;4眼术中发现后囊膜混浊需后期行YAG激光后囊膜切开术。15眼折叠人工晶状体植入囊袋内,2眼植入睫状沟。术后1mo最佳矫正视力≥0.5者16眼,0.4者1眼。结论:超声乳化联合折叠型人工晶状体植入是治疗后极性白内障安全有效的方法。应用连续环形撕囊、轻柔谨慎的水分层而不做水分离,低能量、低吸力、低流量的超声乳化参数设置,手动吸除核周壳和皮质等手术技巧,可以减少手术并发症。

Phacoemulsification in eyes with posterior polar cataract

AIM:To evaluate the clinical features of posterior polar cataract and the surgical technique of phacoemulsification in eyes with posterior polar cataract·METHODS: Case series of 12 patients(17 eyes) with posterior polar cataract who were treated in our hospital from October 2009 to March 2011 were collected.Patients underwent complete ophthalmological examinations including visual acuity,slit-lamp microscopy,and indirect ophthalmoscopy or B-scan ultrasonography.Under peribulbar anesthesia,phacoemulsification was carried out in all cases with foldable intraocular lens(IOL) implantation.The surgical technique,preoperative and postoperative visual acuities,and intraoperative complications were evaluated·RESULTS:All eyes were implanted foldable IOL.Eleven eyes revealed intact and transparent posterior capsule,four eyes revealed posterior capsule opacification which needed YAG laser capsulotomy later.Two eyes developed posterior capsule rupture in which one occurred during division of nucleus and another during aspiration of epinucleus.Fifteen IOL were implanted in the capsular bags,while two IOL were fixed in the ciliary sulcus.In all,16 eyes achieved a best-corrected visual acuity of 20/40 or better one month after operation·CONCLUSION:Phacoemulsification with foldable IOL implantation is an effective and safe method to treat posterior polar cataracts.By continuous curvilinear capsulorhexis,performance of careful and gentle hydrodelineation without hydrodissection,low power,low vacuum and low flux phacoemusification parameters setup,manual aspiration of epinucleus and cortex surgical technique,intraoperative complications could be decreased.