【摘要】 目的 观察双刀劈核法在小切口白内障囊外摘出术中应用的效果。方法 上方距角膜缘1.5mm处作直线形巩膜隧道切口,宽约4.5mm,达透明角膜内1.0mm,于3点和9点方位各作一个侧切口。开罐式截囊或连续环形撕囊,晶状体核浮至前房,Ⅲ～Ⅴ级核用双刀从两个侧切口刺入核赤道部穿过核中心,利用杠杆作用将核劈成两半,用注水晶状体圈匙分别托出。扩大切口,人工晶状体植入囊袋内。结果 124例124眼,术后第1天41眼(33%)局限性角膜水肿,2～5天角膜全部清亮。裸眼视力≥0.5者:术后第1天78眼(62.9%);术后第7天103眼(83.7%);术后1月110眼(88.6%),散光为(0.75±0.50)D。随访6～18月,无影响视力的并发症。结论 此法对硬核手术安全、快速、简便,易于掌握。更多还原

【Abstract】 Objective To observe the clinical effect of two knives horizontal nucleus chopping on small incision extracapsular cataract extraction . Methods About 1.5 mm to the upper limbus of cornea, we made a straight liner shape sceral tunnel incision about 4.5 mm wide and extended into the transparent cornea 1.0 mm,then made two side incision at 3 and 9 o clock. After can-open method or continous curvilinear cap-sularhexis,the nucleus was floated to the anterior chamber.From each affiliated incision,we stabbed two knives into the Ⅲ to Ⅴ grade nucleus from equator to the center.The nucleus was chopped into two pieces for the pry’s principle,and was drawn out by irrigating loop.Then the incision was enlarged. Intraocular lens was implanted into the capsular bag.Results Of the 124 eyes,the first day after the operational cases had localized cornea edema. In two to five days after operation, all the cornea were transparent.The visual acuity was 0.5 or better in 78 eyes (62.9%) on the seventh day and 110 eyes (88.6%) on the thirtieth day.The average astigmatism was 0.75 ± 0.50 D.From 6 to 18 months of followed-up, no complication which affected visual acuity was observed. Conclusion Such method is safe, quick and convenient for chopping the hard nucleus and easy to master.更多还原