高龄白内障患者非超声乳化白内障摘除联合人工晶体植入术36例分析

目的探讨80岁以上高龄老年白内障术式的选择以提高手术效果。方法针对高龄白内障晶状体核大、核硬、角膜内皮细胞减少的生理病理特点,采取把小切口非超声乳化白内障摘除人工晶体植入术的切口扩大为8mm,粘弹剂保证前房操作空间,减少前房内操作保护内皮细胞,一次娩出晶状体核。结果 36例病人晶状体核均为一次顺利娩出。均无后囊破裂。术后角膜轻度水肿3例,均于3-5天消失,两周后裸眼视力>0.4者12例、0.2-0.3者20例、4例0.2以下者均为90岁以上患者,其中3例黄斑变性、1例视神经萎缩。结论 80岁以上高龄老年白内障的手术方法以非超声乳化扩大小切口白内障囊外摘除术为首选。

The analysis of 36 old cases with cataract treated by non-phacoemulsification cataract extraction and intraocular lens implantation

Objetive To investigate the choice of surgical method for aged cataract patients （older than 80）. Methods Because of the characters of big and hard nucleus with less corneal endothelium in aged cataract patients, non-phacoemulsification cataract extraction was undertaken, the incision was enlarged to 8 mm, viscoelastic agents was used to maintain the anterior chamber and actions was reduced to protect endothelium. Results In 36 patients, all of whose lens nucleuses were extracted one time. There is no capsular rupture occurred. Mild corneal edema was observed in 3 cases and disappeared in 3-5 days. After two weeks, uncorrected visual acuity was better than 0.4 in 12 cases, 0.2-0.3 in 20 cases and less than 0.2 in 4 cases, whom were older than 90 and macular degeneration in 3 cases and optic nerve atrophy in 1 case. Conclusion For patients older than 80, non-phacoemulsification cataract extraction with larger incision is the best option.