目的:探讨小瞳孔下超声乳化切除白内障的临床技巧。方法:临床确诊小瞳孔白内障98例116眼。术中应用黏弹剂及人工晶状体调位钩或用虹膜恢复器和囊膜剪扩大瞳孔,撕除虹膜表面机化膜等方法将瞳孔扩大至4～5mm,并在囊袋内完成超声乳化联合人工晶状体术。结果:术中116眼(100%)将瞳孔扩大至4～5mm均顺利完成撕囊及超声乳化术,术后106眼(91.4%)瞳孔恢复。其中8眼(6.9%)后囊破裂,20眼(17.2%)角膜水肿,均于3～5d内消失,6眼(5.2%)未植入人工晶状体。结论:利用黏弹剂及晶状体调位钩或囊膜剪扩大瞳孔等措施能简单有效的扩大瞳孔,不损伤瞳孔括约肌,术后维持瞳孔圆形,且存在瞳孔对光反射,因此在保留瞳孔功能的同时顺利的完成白内障超声乳化手术。

AIM:To explore the surgery techniques of phacoemulsification for treatment of microcoria cataract.METHODS:Ninety-eight cases (116 eyes) of microcoria cataract were firstly operated by using,intraocular lens positioning hook or iris restorer,capsular membrane shear,rearing iris surface organization membrane and any other methods to expand the pupil to 4-5mm,and completed phacoemulsification combined with intraocular lens surgery in capsular bag.RESULTS:Intraoperative 116 eyes (100%) expanded pupils to 4-5mm and successfully completed and phacoemulsification.The postoperative pupils recovered normal in 106 eyes (91.4%),of which 8 eyes(6.9%) had posterior capsule rupture,20 eyes (17.2%) had corneal edema which disappeared in 3-5 days,6 eyes (5.2%) had not intraocular lens implantation.CONCLUSION:Using intraocular lens positioning hook,capsular membrane shear and any other methods can simply and effectively expand the pupil without damaging,also maintaining the pupil circular postoperatively,and existing papillary light reaction.So phacoemulsification can successfully complete and preserve the pupil function at the same time.

R779.66