【摘要】 探讨完美超声乳化术的定义、标准及影响因素,并讨论、介绍手术技巧。完美的定义:术后效果与术前预计的一样,让医生和患者都满意。标准包括:患者无不适主诉;术后视功能恢复正常指标;角膜、房水、虹膜、瞳孔如术前,人工晶状体位居中,后囊完整、无混浊或皱折;术后眼压正常。影响完美的因素包括患者的选择、医生的素质及医院设备。如何达到完美?需要严格的术前准备、术中操作、术后用药整套的规范操作。着重介绍并探讨手术技巧,主张在屈光力强的力轴上做透明角膜隧道切口,要求切口的形状和大小标准,将高质量粘弹剂注入前房,做大小适中的正中的连续环形撕囊,彻底水分离后,以“高负压、低能量,多机械劈核”为原则进行超声乳化,对不同核硬度、不同超声乳化阶段设定不同的负压、能量、流量,植入可减少后发性白内障的人工晶状体。总之,超声乳化技术的掌握需要一个“学习曲线”,术中做到“两手、两脚、两眼、两耳、一脑”的协调配合,不断总结经验,将各种手法融会贯通,才能日趋完美。更多还原

【Abstract】 This article deals with the definition, standards and relative factors of perfect phacoemulsification and on this basis, surgical manipulations are introduced. Phacoemulsification is regarded as perfect when the actual surgical outcome conforms to what is expected and both surgeons and patients are satisfied. Its norms consist of no complaints about discomfort, recovery of visual function to normal, cornea, aqueous fluid, iris and pupil at pre-operative state, central location of intraocular lens, intact, smooth posterior capsula, normal IOP. The relative factors include patients’ condition, surgeons’ qualification and hospital equipment. In operation, clear tunnel incision, in standard size and shape, is firstly made on cornea and along the highly refractive axia. Then, viscolastic is infused into anterior chamber and continuous, circular, central capsulorhexis should be performed. After thorough hydrodissection, nucleus is phacoemulsi- fied according to the principle of high vacuum, low energy and mechanical chop. Phacoemulsification differs with the degrees of cataract and the stages of surgery. In the end,anti-opaque lens are implanted and after surgery, antibiotics and hormone are used.更多还原