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引用:杨永利,张旭,高晓唯.辅助技术在治疗白内障合并角膜混浊手术中的应用.国际眼科杂志 2020;20(8):1460-1463,doi:10.3980/j.issn.1672-5123.2020.8.36
辅助技术在治疗白内障合并角膜混浊手术中的应用
Application of assistive technology in the treatment of cataract with corneal opacification
投稿时间:2019-12-26  修订日期:2020-07-01
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DOI:10.3980/j.issn.1672-5123.2020.8.36
关键词:  角膜混浊  白内障  超声乳化摘除术  囊膜染色剂
Key Words:  scorneal opacity  cataract  phacoemulsification  capsular stain
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作者单位
杨永利 中国新疆维吾尔自治区乌鲁木齐市,新疆军区总医院全军眼科中心
张旭 中国新疆维吾尔自治区乌鲁木齐市,新疆军区总医院全军眼科中心
高晓唯 中国新疆维吾尔自治区乌鲁木齐市,新疆军区总医院全军眼科中心
        
AuthorInstitution
Yong-Li Yang Army Eye Center, Xinjiang Military General Hospital, Urimqi , Xinjiang Uygur Autonomous Region, China
Xu Zhang Army Eye Center, Xinjiang Military General Hospital, Urimqi , Xinjiang Uygur Autonomous Region, China
Xiao-Wei Gao Army Eye Center, Xinjiang Military General Hospital, Urimqi , Xinjiang Uygur Autonomous Region, China
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目的:评价在白内障手术中应用包括囊膜染色、虹膜拉钩、虹膜切除等辅助技术治疗白内障合并角膜混浊患眼的术后视觉效果,并分析手术安全性和有效性。

     方法:回顾收集2014-01/2019-03在新疆军区总医院全军眼科中心接受白内障超声乳化合并人工晶状体植入术的白内障合并角膜混浊患者105例105眼,所有患者接受白内障超声乳化摘除并人工晶状体植入术。术中应用台盼蓝囊膜染色剂,并观察前囊膜染色情况,连续环形撕囊成功率,晶状体后囊破裂及人工晶状体囊袋内植入情况。并于术后1d,1wk,1、3mo对患者进行随访,观察术中撕囊成功率,术前、术后的最佳矫正视力(BCVA,LogMAR),术后并发症等。

     结果:患者均接受白内障超声乳化吸除合并人工晶状体植入术。术中通过应用台盼蓝囊膜染色剂(台盼蓝)染色前囊膜辅助成功完成所有连续环形撕囊,并采取了包括应用虹膜拉钩及虹膜切开术等其他措施。将可折叠式人工晶状体植入105眼。术后追踪观察3mo,术眼术后BCVA为0.82±0.10,与术前BCVA(3.12±0.14)比较有差异(t=174.893,P<0.01)。

     结论:白内障超声乳化摘除术能使白内障合并角膜混浊患者的视力得到安全有效的提高。辅助技术如囊膜染色、虹膜拉钩、虹膜切除等的应用,能有效降低白内障合并角膜混浊患者的白内障手术风险,提高手术安全性,增加手术成功率。

Abstract:
      AIM: To evaluate the postoperative visual effects of assisted techniques such as cystic membrane stainin, iris hooking, and iris incision to treat cataract patients with corneal opacities, and analyze the safety and effectiveness of the surgery.

     METHODS: A retrospective collection of 105 cases(105 eyes)of cataract patients with corneal opacities who underwent cataract phacoemulsification combined with intraocular lens implantation at the Army Eye Center of Xinjiang Military Region General Hospital from January 2014 to March 2019. All patients received cataract phacoemulsification removal and intraocular lens implantation. Apply the trypan blue capsule staining agent during the operation and observe the anterior capsule staining, the success rate of continuous annular capsulorhexis, the rupture of the posterior lens capsule and the implantation of the intraocular lens capsule. Patients were followed up at 1d, 1wk, 1 and 3mo after surgery. Observe the success rate of capsulorhexis during operation, the best corrected visual acuity(BCVA, LogMAR)before and after surgery, and postoperative complications.

     RESULTS: All patients underwent phacoemulsification with intraocular lens implantation. During the operation, all continuous ring-shaped capsulorhexis were successfully completed through the application of trypan blue capsule staining(trypan blue)dye, and other measures including application of iris hook and irisotomy were taken. A foldable intraocular lens was implanted in 105 eyes. After 3mo of follow-up observation, the BCVA of the operation eye was 0.82±0.10 compared with the preoperative BCVA 3.12±0.14,and there were statistical differences(t=174.893, P<0.01).

     CONCLUSION: Cataract phacoemulsification can safely and effectively improve the vision of patients with cataract and corneal opacity. The application of assistive technologies such as capsule staining, iris hooking, and iris resection can effectively reduce the risk of cataract surgery in patients with cataract and corneal opacity, improve the safety of surgery, and increase the success rate of surgery.

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