【摘要】 目的 探讨小瞳孔晶状体乳化手术中撕囊及劈核的手术技巧、并发症及近期临床效果。方法 对32例(41眼)散瞳后瞳孔在4mm以下的白内障患者,采用黏弹剂或非切开方法扩大瞳孔,行前囊连续环形撕囊和乳化前深埋手法劈核,超声乳化并植入人工晶状体。结果 除2例(2眼)外伤性白内障因前囊机化,用囊剪协助撕囊以外,其余全部环形撕囊成功;所有劈核超声乳化顺利。无一例后囊破裂,无一例角膜内皮失代偿。术后1周和1月,裸眼视力≥0.5者分别为25眼(66.97％)及35眼(85.37％),而术后1月视力提高2行以上者39眼(95.12％)。结论 小瞳孔白内障并非连续环形撕囊及劈核超声乳化手术的相对禁忌症,应用合理的手术技巧,可以获得良好的临床效果。更多还原

【Abstract】 Objective To study the surgical techniques of chopping and continuous circular capsulorhexis ( CCC) in phacoemulsification in the state of small pupil, and the complications and recent clinical effects were also observed.Methods 41 eyes of cataract(32 cases) with pupil diameter less than 4 mm after the use of mydriatics were operated by using vis-coelastic or nonincisional pupilloplasty first,then CCC and manual-chop with embedding in emulsification. Intraocular lens(IOL)was implanted in each eye finally. Results CCC was done smoothly in all eyes, excision was used in 2 eyes because of their organized anterior capsules. All processes in chopping, emulsification and IOL impantation were performed successfully with no posterior capsular rupture. Postoperatively, there was no corneal decompensation; The uncorrected visual acuities of 25 eyes (66.96%) and of 35 eyes (85.37%) were 3≧0.5 at one week and at one month respectively,and of 39 eyes (95.12%) were improved more than 2 lines. Conclusion Cataract with small pupil is not the contraindication of emulsification in CCC and chopping. Better clinical effects can be achieved by using reasonable surgical techniques.更多还原