双切口联合双钩娩核白内障囊外摘除术在复明工程中应用的短期效果

 目的  评价双切口联合双钩娩核白内障囊外摘除术在复明工程中的短期应用效果。设计 回顾性病例系列。研究对象 2012年9月-2015年2月沧州眼科医院行双切口联合双钩娩核白内障囊外摘除术患者305例（342眼）。方法 所有患者均行双切口联合双钩娩核白内障囊外摘除术，记录手术时间，术中、术后并发症情况，利用标准视力表测量裸眼视力，根据脱残程度将视力分为≥0.05、≥0.3、≥0.5三个等级，非接触式眼压计测量眼压，角膜地形图测量角膜散光，术后1个月时再次检查并与术前的各项指标进行对比。主要指标 手术时间、裸眼视力、眼压、角膜散光，手术并发症。结果 手术平均时间（4.1±0.2）分钟，术后1个月裸眼视力≥0.05者338眼（98. 83%），≥0.3者305眼（89.18%），≥0.5者179眼（52.34%）；矫正视力≥0.5者251眼（73.39%）。术中、术后并发症：虹膜损伤瞳孔轻度变形者2眼（0.58%），人工晶状体未能一期植入者1眼（0.29%），需缝合巩膜隧道切口1眼（0.29%），术后角膜水肿39眼（11.4%），术后暂时性高眼压12眼（3.50%）。手术1个月后角膜平均散光（0.93±0.33）D与术前（0.89±0.36）D比较无统计学差异（P=0.12）。结论 双切口联合双钩娩核白内障囊外摘除术手术时间短，对基层医院不失为防盲复明手术的选择术式。（眼科，2016，25： 82-85）

The effect of double incision joint nuclear extraction with two-dialer in extracapsular cataract extraction procedure for restoring-vision cataract projects

 Objective To evaluate the effect of double incision joint nuclear extraction with two-dialer in extracapsular cataract extraction (ECCE) procedure for restoring-vision cataract projects. Design Retrospective case series. Participants We retrospectively analyzed the 305 patients (all 342 eyes) who underwent the double incision joint nuclear extraction with two dialers ECCE from September 2012 to February 2015. Methods All patients were treated in our hospital with double incision joint nuclear extraction with two-dialer ECCE, and the operation time, intraoperative and postoperative appeared complications were recorded. Uncorrected visual acuity (UCVA) was measured with standard Snellen visual charts, and was classified into ≥ 0.05, ≥ 0.3, ≥0.5. Non-contact tonometer was used to measure intraocular pressure (IOP). Corneal topography was used to measure K1 and K2 to determine the astigmatism. The measurements were repeated 1 month after surgery and compared to corresponding pre-operative values. Main Outcome Measures The average time length of operation, UCVA, IOP, corneal astigmatism, posterior capsule rupture, pupil deformation, and corneal edema. Results The average time length of operation was 4.1±0.2 min. There were 338(98. 83%) eyes whose post-operative UCVA ≥ 0.05, 305(89. 18%) eyes ≥0.3, and 179(52.34%) eyes ≥0.5. There were 251(73.39%) eyes whose post-operative best-corrected visual acuity ≥ 0.5. No posterior capsular rupture (PCR) happened. Mild pupil deformation due to iris injury during surgery happened in 2 eyes (0.58%). One eye (0.29%) couldn't implant artificial lens, 1 eye (0.29%) needed suture the scleral tunnel incision.  Post-operation corneal edema happened in 39 eyes (11.4%) and 12 eyes (3.50%) suffered transient intraocular hypertension post-operatively. The average corneal astigmatism was (0.93±0.33) D after 1 month, not significantly different from (0.89±0.36) D before the operation (P=0.12). Conclusions During restoring-vision cataract projects, double incision joint nuclear extraction with two dialers in ECCE procedure is safe and effective, could be the primary choice for primary hospitals. （Ophthalmol CHN，2016，25： 82-85）