手法娩核在硬核超声乳化手术中应用的研究

目的探讨硬核白内障超声乳化人工晶状体植入手术的技巧和效果。方法对Ⅳ级和Ⅴ级硬核白内障39例(39眼)施行超声乳化联合手法娩核手术,观察术中术后并发症、术后视力及角膜水肿等并进行分析。结果超声乳化时间为0.3～0.8min,平均0.5min。切口无热损伤,无严重并发症发生。全部39例均顺利一期囊袋内人工晶状体植入。术后1周视力≥0.5者29眼占74.36%,术后1月视力≥0.5者34眼占87.18%,其中视力≥1.0者8眼占20.51%。视力≤0.1的3眼(7.69%)中2眼为老年性黄斑变性,1眼为糖尿病性视网膜病变。结论超声乳化联合手法娩核技术可以降低超声能量,具有损伤小、术中术后并发症少、手术时间短、术后反应轻和视力恢复快等优点,是硬核白内障的可供选择的较好的手术方式。

Use of manual nuclear extraction in phacoemulsification for hard nuclear cataract

Objective To investigate the surgical skill and effect of phacoemulsification and intraocular lens (IOL)implantation in hard nuclear cataract. Methods 39 cases(39 eyes) of cataract with grade IV and V hard nuclear under went phacoemulsification combined with manual nuclear extraction. Intraoperative and postoperative complications, postoperative visual acuity and corneal edema were observed. Results The phacoemulsification time was 0.3-0.8 min, averaged 0.5 min. No heat damage to the incision and other severe complications took place. IOLs were successfuly implanted to capsular bag in all patients.One week after surgery,visual acuity was 0.5 or better than it in 29 eyes (74.36%)and one month after surgery it was better than 0.5 in 34 eyes (87.18%),among them visual acuity in 8 eyes(20.51%) was better than 1.0 and it was less than 0.1 in 3 eyes,2 of these 3 eyes were ARMD and 1 eye was diabetic retinopathy. Conclusion Phacoemulsification combined with manual nuclear extraction can decrease ultra sound power and has the advantages of little damage and complication,short surgical time, little surgical reaction and fast visual rehabilitation. It is one of better surgical techniques for hard nuclear cataract.