本文選題：白色障 + 膨脹性�。� 參考：《西南醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:研究微小撕囊對提高膨脹性白色障超聲乳化吸除術(shù)成功率的臨床意義。方法:收集2014年2月至2015年8月,膨脹性白色障18例18眼。與2013年1月2014年1月完成的25例25眼,進(jìn)行回顧性研究。微小撕囊的手術(shù)方法:囊膜染色或不染色,截囊針刺破前囊膜,吸出部分乳液和皮質(zhì),做2mm微小環(huán)形撕囊,注吸頭通過撕囊口將皮質(zhì)或乳糜液吸出,使囊袋內(nèi)僅殘留晶體核,二次撕囊直徑5-5.5mm,常規(guī)超乳。結(jié)果:微小撕囊組18眼,有2例前囊膜裂開,無后囊膜破裂,連續(xù)環(huán)形撕囊成功率為88.89%。術(shù)后1d,3例后彈力層略有皺襞伴角膜輕度水腫;對照組10例前囊膜破裂,連續(xù)環(huán)形撕囊成功率為66.67%。2例后囊膜破裂,1例核塊墜落,5例角膜水腫,2例眼壓輕度升高。連續(xù)環(huán)形撕囊成功率微小撕囊組高于常規(guī)撕囊組,兩組比較差異均有統(tǒng)計(jì)學(xué)意義。結(jié)論:微小撕囊法能顯著提高膨脹性白色障環(huán)形撕囊的成功率,降低手術(shù)難度,有效提高超乳成功率。目的:研究過熟性白色白內(nèi)障超聲乳化吸除術(shù)的手術(shù)技巧并評價(jià)其效果。方法:收集2013年2月至2015年8月,過熟性白色白內(nèi)障24眼。與2013年1月2014年5月,過熟核常規(guī)超乳+ECCE手術(shù)24例,進(jìn)行回顧性研究。IOL預(yù)植入超乳手術(shù)方法:先在核中央乳化出一深直溝槽,再將核一分為二劈裂,重復(fù)劈核,將一個(gè)1/2核塊再分成2塊,然后用脈沖能量乳化掉。在囊袋內(nèi)注入粘彈劑,此時(shí)于晶體核下植入人工晶狀體于囊袋內(nèi),在人工晶體的保護(hù)下,將剩下的1/2核塊再分成2塊,常規(guī)超乳去除剩余1/2核,吸除殘留皮質(zhì),完成手術(shù)。結(jié)果:實(shí)驗(yàn)組24例囊袋完整23例,單側(cè)前囊膜裂開1例,無后囊膜破裂;對照組24例,囊袋完整17例,單側(cè)前囊膜裂開2例,雙側(cè)前囊膜裂開1例,后囊膜破裂4例。兩種方法對于術(shù)中囊袋的安全性比較有顯著性差異(p0.05)。兩組術(shù)后第1,7d角膜透明度比較有顯著性差異(p0.05)。術(shù)后第1d裸眼視力組間比較有顯著差異(P0.05)。術(shù)后7d最佳矯正視為組間比較無顯著差異(P0.05)。實(shí)驗(yàn)組術(shù)后1月內(nèi)皮計(jì)數(shù)2314±278/mm2,對照組內(nèi)皮計(jì)數(shù)2298±256/mm2。2組比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:IOL預(yù)植入法能安全的完成過熟性白色障的超乳手術(shù),減少超乳手術(shù)中后囊膜破裂的風(fēng)險(xiǎn),提高超乳的成功率,同時(shí)使患者獲得較好的裸眼視力,無額外的風(fēng)險(xiǎn),為安全的手術(shù)方式。
[Abstract]:Objective: to study the clinical significance of small capsulorhexis in improving the success rate of phacoemulsification of swelling white barrier. Methods: from February 2014 to August 2015, 18 eyes of 18 patients with swelling white barrier were collected. A retrospective study was conducted in 25 cases (25 eyes) completed in January 2014. The operative methods of microcapsulorhexis were as follows: the capsule membrane was stained or not stained, the capsule needle punctured the anterior capsule, part of the emulsion and cortex were sucked out, and the 2mm microannular capsulorhexis was made. The suction head sucked out the cortex or chylous fluid through the capsulorhexis, so that only the residual crystal nucleus could be found in the capsule bag. The secondary capsulorhexis was 5-5.5 mm in diameter. Results: in the group of small capsulorhexis, there were 2 cases with rupture of anterior capsule, no rupture of posterior capsule, and the success rate of continuous circular capsulorhexis was 88.89%. One day after operation, there were 3 cases of posterior elastic layer with slight corneal edema and 10 cases of anterior capsule rupture in the control group. The success rate of continuous circular capsulorhexis was 66.67.2 cases with posterior capsule rupture, 1 case with nuclear mass falling and 5 cases with corneal edema and 2 cases with slight increase of intraocular pressure. The success rate of continuous circular capsulorhexis was higher in the microcapsulorhexis group than in the conventional group, and the difference between the two groups was statistically significant. Conclusion: the microcapsulorhexis method can significantly improve the success rate of circular capsulorhexis of swelling white barrier, reduce the difficulty of operation and improve the success rate of superemulsion. Objective: to study the surgical techniques and evaluate the effect of phacoemulsification for overmature white cataract. Methods: from February 2013 to August 2015, 24 eyes of overmature white cataract were collected. A retrospective study was performed on 24 cases of conventional superemulsion ECCE operation with overmature nucleus in May, 2013. The method of pre-implantation of superemulsion was studied: first emulsifying a deep groove in the center of the nucleus, then splitting the nucleus into two parts and splitting the nucleus repeatedly. Divide a 1 / 2 nuclear block into two pieces and emulsify them with pulse energy. Under the protection of intraocular lens, the remaining 1 / 2 nucleus was subdivided into two pieces, the remaining 1 / 2 nucleus was removed by conventional superemulsion, the residual cortex was sucked, and the residual cortex was removed. Results: in the experimental group, 24 cases had intact capsule, 1 case had unilateral rupture of anterior capsule, and 24 cases in control group, 17 cases had intact capsule, 2 cases had unilateral rupture of anterior capsule, 1 case had bilateral rupture of anterior capsule and 4 cases had rupture of posterior capsule. There was significant difference between the two methods in the safety of intraoperative p0. 05 p0. 05. There was a significant difference in corneal transparency between the two groups on the 1st day after operation (P 0.05). On the first day after operation, there was a significant difference in the uncorrected visual acuity between the two groups (P 0.05). At 7 days after operation, the best correction was regarded as no significant difference between the two groups (P 0.05). The endothelium count was 2314 鹵278mm2 in the experimental group and 2298 鹵256/mm2.2 in the control group. There was no significant difference in the endothelium count between the experimental group and the control group (P 0.05). Conclusion the overmature white barrier suckling surgery can be safely performed by the preimplantation of 10% IOL, which can reduce the risk of posterior capsule rupture, increase the success rate of suckling, and at the same time, make the patients obtain better naked vision without any additional risk. For safe operation.
【學(xué)位授予單位】：西南醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R779.66

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