28例小瞳孔状态下小切口白内障手术的临床疗效观察

目的探讨小瞳孔状态下行小切口碎核白内障摘除联合人工晶体植入术的临床疗效。方法回顾性分析2011年7月至2013年7月在我院行小切口碎核自内障摘除联合人工晶体植入术的小瞳孔白内障患者28例（28眼），术中根据患者实际情况，分别采用粘弹剂推注力钝性分离及虹膜切开法扩大瞳孔，术后随访1至6个月，重点观察记录患者术后并发症、视力及瞳孔状态。结果术后随访28例患者视力均有不同程度提高，术后1月视力0．1—0．3者6例，〉0.3者22例，其中〉0．6者占10例，除1例患者术后瞳孔上移、1例瞳孔不规则散大，余26例眼瞳孔均恢复正圆状态，直径2．5—4mm，所有患者均无严重并发症发生。结论小瞳孔状态下行小切口碎核白内障摘除联合人工晶体植入术，术中利用粘弹剂推注力钝性分离及虹膜切开法扩大瞳孔是一种安全有效的手术方法。

The clinical effect of small incision cataract surgery in 28 patients with small pupil.

Objetive To investigate the clinical effect of small incision cataract extraction with nucleus division and intraoeular lens implantation for patients with small pupil. Methods We retrospectively analyzed 28 cataract patients with small pupil that underwent small incision cataract extraction with nucleus division and intraocular lens implantation from July, 2011 to July, 2013. According to the actual situation of patients, the pupil was enlarged by the blunt dissection of viscoelastic material or irideetomy. Moreover, all cases were followed up for 1 to 6 months. The complication, the visual acuity and the condition of pupil after operation were observed and recorded. Results 28 cases got better visual acuity ＂after surgery, the corrected visual acuity was 0.1-0.3 in 6 eyes, above 0.3 in 22 eyes and above 0.6 in 10 eyes. Except for 1 pupil being moved to the upper and 1 pupil scattered irregularly, the other 26 pupils all have returned to their normal size and shape after operation. Furthermore, no serious complication within one month has been found. Conclusion Dilating the pupil by using the blunt dissection of viscoelastic material or iridectomy is a safe and effective method in small incision cataract extraction with nucleus division and intraocular lens implantation for patients with small pupil.