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目的探讨2mm微切口冷超声乳化白内障摘除术技术及可行性,评价其临床疗效。方法我们对86例(117只[)老年性白内障施行了双切口冷超声乳化白内障摘除并2mm微切口折叠人工晶体植入术。对灌注劈核器进行了相应改造,对超声乳化仪技术参数进行了筛选调整。于3点和11点方位角巩膜缘分别行1.2mm×1.2mm、1.5mm×1.2mm切口,灌注劈核器、超声乳化无套管探头分别通过双切口进入前房,超声能量采用间歇释放/强度线性调整模式,采用快速劈裂法乳化核组织,扩大切口至2mm植入折叠式人工晶体。观察手术中超声能量应用情况、乳化时间、术中术后并发症,追踪观察术后视力及散光情况。结果超声能量和乳化时间:核硬度为II级者平均应用能量(3%)/平均乳化时间为(0.57±0.37)min;III级核平均应用能量(8%)/平均乳化时间为(068±0.58)min;IV级核平均应用能量(11%)/平均乳化时间为(1.35±0.95)min。术后首日裸[视力≥0.5者占94.3%,≥1.0者占40.5%;术后一周,平均散光(0.76±0.59)D,与术前散光比较无显著性差异(p>0.05)。117只[中,9只[(7.7%)术后切口周围浸润水肿,1-2天后恢复透明,无角膜切口灼伤、严重水肿、后囊破裂、切口漏液、前房异常等并发症。结论微切口冷超声乳化白内障摘除手术具有良好的临床疗效,为更新人工晶体的研发奠定了基础。具有临床的可操作性和开拓价值。
Objective To investigate the technique and feasibility of 2mm micro-incision cold phacoemulsification cataract extraction and evaluate its clinical efficacy. Methods We performed a double-incision cold phacoemulsification cataract extraction and a 2 mm micro-incision foldable intraocular lens implantation in 86 patients (117 elderly) with cataract. The perfusion chopping core was modified accordingly, and the technical parameters of the phacoemulsification instrument were screened and adjusted. At the 3 o’clock and 11 o’clock azimuths of the scleral margin were 1.2mm × 1.2mm, 1.5mm × 1.2mm incision, perfusion chopper, phacoemulsification without cannula probe through the double incision into the anterior chamber, ultrasonic energy using intermittent release / Intensity linear adjustment mode, rapid cleavage emulsified nuclear organization, expand the incision to 2mm implant foldable intraocular lens. Observe the application of ultrasonic energy during surgery, emulsification time, intraoperative and postoperative complications, follow-up observation of visual acuity and astigmatism. Results The ultrasonic energy and emulsification time: the average applied energy (3%) and the average emulsification time (0.57 ± 0.37) min for the nuclear hardness grade II and the average applied energy (8%) and the average emulsification time 0.58) min. The average application energy of Grade IV core (11%) / average emulsification time was (1.35 ± 0.95) min. On the first day after operation, the average numbness of visual acuity ≥0.5 (94.3%, ≥1.0%) was 40.5%. One week after operation, the average astigmatism (0.76 ± 0.59) D had no significant difference with preoperative astigmatism (p> 0.05). A total of 117 [9 (7.7%) infiltrated edema around the incision after operation, and recovered after 1-2 days. No corneal incisional burns, severe edema, rupture of the posterior capsule, incision leakage and anterior chamber abnormalities were observed. Conclusion Micro-incision cold phacoemulsification cataract surgery has good clinical efficacy, which lays the foundation for the research and development of newer intraocular lens. With clinical operability and pioneering value.