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目的探讨微切口超声乳化白内障摘除术的可行性和疗效。设计前瞻性、非对照病例研究。研究对象 112例 (134眼)单纯老年性白内障患者。方法对所有研究对象施行双手微切口超声乳化白内障摘除术。用1．2 mm和1．4 mm小切口专用穿刺刀,于颞上和鼻上方分别作1.2 mm和1．4 mm的透明角膜隧道切口,自1.2 mm切口伸入20号的灌注劈核器,1．4 mm 切口伸入去除硅胶套的19G乳化针头,以快速晶状体劈核技术双手配合进行手术。扩大切口植入折叠式人工晶状体。主要指标观察术后视力、前房稳定性、房水闪辉细胞及角膜内皮细胞计数。结果术中平均超声乳化时间(3．63±1．55)秒,术后1天、1 周及1个月,裸眼视力≥0．5的术眼分别占53．3％、83．3％及96．7％,术后1天、1周及1个月激光房水蛋白细胞分别为(19．51± 1．31)光子数／毫秒(pc／ms)、(10．51±0．71)pc／ms、(5．90±0．94)pc／ms,1周及1个月角膜内皮细胞计数分别为(2317±812)个／mm2 和(2619±533)个／mm2。术中前房突然消失3眼、后囊损伤1眼、前囊损伤3眼、虹膜损伤6眼。结论双手微切口白内障超声乳化可在<1．5 mm的切口完成,但存在切口渗漏、粗大带灌注劈核器操作易造成虹膜损伤和囊膜破裂等问题,因此手术技巧或手术器械尚需进一步改进和完善。
Objective To investigate the feasibility and efficacy of micro-incision phacoemulsification cataract extraction. Design prospective, uncontrolled case study. Study object 112 cases (134 eyes) simple senile cataract patients. Methods All subjects underwent both-hand micro-incision phacoemulsification cataract extraction. With 1.2 mm and 1.4 mm small incision dedicated puncture knife, on the superior temporal and nasal top were 1.2 mm and 1.4 mm clear corneal tunnel incision, incision from the 1.2 mm incision into the No. 20 perfusion chopper , 1.4 mm incision into the silicone sleeve to remove the 19G emulsion needle, with rapid intraoperative nucleus pulposus surgery with both hands. Expand the incision implanted foldable intraocular lens. The main indicators of postoperative visual acuity, stability of anterior chamber, aqueous humor cells and corneal endothelial cell count. Results Intraoperative average phacoemulsification time (3.63 ± 1.55) s, 1 day, 1 week and 1 month after surgery, visual acuity ≥ 0.5 eye accounted for 53.3%, 83.3% And 96.7%, respectively. The mean values of laser photoreceptor protein (PCL) / (pc / ms) and (10.51 ± 0.31) The number of corneal endothelial cells in the first week and the second month were (2317 ± 812) / mm2 and (2619 ± 533) / mm2, respectively. Intraoperative anterior chamber suddenly disappeared 3 eyes, 1 posterior capsule injury, 3 anterior capsule injury, 6 iris injury. Conclusions Two-hand micro-incision phacoemulsification can be performed in an incision of <1.5 mm, but there is incision leakage. The operation of coarse perfusion chopper can easily lead to iris damage and rupture of the capsular bag. Therefore, surgical techniques or surgical instruments are still needed To further improve and perfect.