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目的探讨瞳孔缘虹膜环形剪除成形在粘连性小瞳孔白内障超声乳化术的安全性和手术技巧。方法对23例34眼(实验组)粘连性小瞳孔的白内障患者采用瞳孔缘虹膜环形剪除成形,进行原位超声乳化联合人工晶状体植入术;选择34例同一术者完成的排除眼部疾病的白内障患者作为对照组,采用经巩膜隧道切口的白内障超声乳化手术。观察手术前后两组视力及角膜内皮变化。结果术后随访6个月,所有病例术后矫正视力较术前有不同程度的提高。实验组术后视力低于0.1者3眼;0.1-0.3者3眼;0.3-0.6者12眼;高于0.6者16眼。与对照组比较,实验组手术前后内皮细胞丢失率无统计学差异。结论对粘连性小瞳孔的白内障患者采用瞳孔缘虹膜环形剪除成形法,可以保证超声乳化术安全进行,术后视力恢复理想,手术并发症少。
Objective To investigate the safety and surgical skills of phalanx cystectomy in the treatment of small pupil cataract phacoemulsification. Methods The cataract patients with small pupil of adhesive small pupil in 23 eyes (experimental group) were treated by phacoemulsification combined with intraocular lens implantation (IOLI). 34 cases with the same operation were selected to exclude eye diseases Cataracts as a control group, scleral tunnel incision phacoemulsification surgery. Visual acuity and corneal endothelial changes were observed before and after surgery. Results All cases were followed up for 6 months. The corrected visual acuity in all cases was improved to some extent compared with that before operation. The experimental group had visual acuity of less than 0.1 in 3 eyes, 0.1-0.3 in 3 eyes, 0.3-0.6 eyes in 12 eyes and more than 0.6 eyes in 16 eyes. Compared with the control group, there was no significant difference in the rate of endothelial cell loss before and after operation in the experimental group. Conclusions For cataract patients with small pupil of adhesion, pupillary edge iris ring circumcision is used to ensure the phacoemulsification safely. The postoperative visual acuity recovery is satisfactory and there are few complications.