目的:探讨在小瞳孔状态下白内障手术的操作方法和技巧。方法:对42例46眼小瞳孔白内障患者,行巩膜隧道小切口,利用黏弹剂钝性分离虹膜后粘连或瞳孔缘放射状剪开的方法扩大瞳孔,白内障囊外摘出,植入后房型人工晶状体。结果:术后随访6~18mo,所有病例术后视力均有不同程度提高。最佳矫正视力0.04~0.1者8眼(17%),0.2~0.5者18眼(39%),0.6~1.0者20眼(44%),其中视力<0.1者均为眼后段病变所致,未出现严重并发症。结论:掌握好手术适应证和手术技巧,小瞳孔下小切口白内障摘除及人工晶状体植入手术同样能取得良好的临床效果。

AIM:To explore the surgical techniques and the techniques of the small pupil cataract surgery. METHODS: Small scleral tunnel incision 42 cases(46 eyes) of small pupil cataract patients. We use viscoelastic solution after blunt separation of posterior synechia, or pupillary margin of radial cut to expand the pupil, extracapsular cataract extraction, and then plant intraocular lens(IOL). RESULTS: Following up 6 to 18 months,Visual acuity improved in all cases. Postoperative best corrected visual acuity was 0.04- 0.1 in 8 eyes(17%) , 0.2- 0.5 in 18 eyes (39%),0.6-1.0 in 20 eyes (44%) . Visual acuities less than 0.1 were attributed to posterior segment abnormalities. No serious complications were found. CONCLUSION: When we select the right indications and surgical techniques properly, cataract extraction and IOL implantation through small pupils with small incision of scleral tunnel can obtain good clinical effects.

R779.66