白内障超声乳化术中囊膜阻滞综合征的诊治

目的 总结白内障超声乳化术中囊膜阻滞综合征的诊治经验。方法 1997年6月～2000年6月3a内1252例白内障患者行超声乳化联合后房型人工晶状体植入术，发现5例患者（5眼）在行环行撕囊、水分离后眼压突然升高、前房变浅、虹膜前移、晶状体核与环行撕囊后的前囊膜紧贴。其中初始1例发生晶状体后囊破裂、晶状体核坠入玻璃体腔，对此1例进行玻璃体切割联合巩膜缝线固定后房型人工晶状体植入术。之后4例用冲洗针头轻轻地拨动晶状体核，使前房与晶状体核后空间沟通，眼压下降，并顺利完成超声乳化联合后房型人工晶状体植入术。结果 患者经术中处理后眼压均恢复正常。术后1周视力达0.5～0.7。结论 囊膜阻滞综合征是与环行撕囊相关的一种并发症。对此并发症的认识将有助于采取恰当的术中防治措施。

Dignosis and treatment of intraoperative capsular block syn drome in phacoemulsification

Objective To summarize experience of diagnosis and treatment of intraoperative capsular block syndrome(CBS) in phacoemulsification.Methods The cataracts having undergone phacoemulsification and intraocular lens (IOL) implantation were reviewed during the period from June,1997 to June,2000.Five cases(5 eyes) with cataract were found having common character of an abrupt shallowing of the anterior chamber,high intraocular pressure as the nucleus moved forwards induced by continuous curvilinear capsulorhexis(CCC) and hydrodissection.For the capsule ruptured in the first case and the nucleus dropped into vitreous cavity following CCC and hydrodissection,the patient had to be performed vitrectomy and scleral fixation of IOL.The other 4 cases were made intraocular pressure to fall by channelling anterior chamber to capsular bag behind nucleus by washing pinhead moving nucleus gently.The latter were then performed phacoemulsification and posterior chamber IOL successfully. Results Intraocular pressure of 5 cases reverted to normal condition after intraoperative treatment.Visual acuity were 0.5 or better at 7 days postoperatively.Conclusion CBS is a complication related to CCC.It is important to understand and deal with intraoperative CBS properly.