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目的 探讨如何减少和避免从白内障囊外摘除术到超声乳化吸除术过渡中的手术并发症。方法 对70例79眼超声乳化白内障吸除术的术中术发并发症进行了分析。结果 术中并发症玻璃体脱出9例,占12％,其中3例为晶状体翻转时活动度过大晶状体缘割破后囊,2例在追逐游窜的晶状体碎核时误吸后囊,1例灌注时由于灌注压过大撑破后囊,1例发生在乳化锅底样白内障进损伤后囊,2例因撕囊失败,改开罐式截囊,乳化头吸住边缘不整齐的前囊膜造成后囊破裂。误吸虹膜3例。6点位虹膜跟部断离1例。术后最常见的并发症是角膜水肿,占40％,与手术者操作技术不娴熟,超声能量过大,乳化时间过长有关。前房内乳化晶状体核、前房涌动、浅前房时乳化头对角膜内皮的损伤,是导致重度角膜水肿的原因。结论 连续环形撕囊和乳化晶状体核是乳化手术的关键。我们的资料表明,只要我们熟练掌握了囊外摘除技术并认真学习超声乳化理论知识,经过认真的训练和实践,就能减少并发症,较快的掌握超声乳化技术。
Objective To explore how to reduce and avoid the complications of surgery from extracapsular cataract extraction to phacoemulsification. Methods 70 cases of 79 cases of phacoemulsification cataract surgery complications were analyzed. Results Complications of intraoperative vitreous prolapse in 9 cases, accounting for 12%, of which 3 cases of lens turnover over the lens edge cutting the posterior capsule, 2 cases in the pursuit of channeling lens crushing aspiration mistress the posterior capsule, 1 case During perfusion, the perfusion pressure was too large to break the posterior capsule. One case occurred in the end of the emulsified pot-like cataract into the posterior capsule. Two cases failed due to capsulorhexis. The anterior capsule Posterior capsule caused by membrane rupture. Inhalation iris in 3 cases. 6:00 Iris and healed off in 1 case. The most common complication after surgery is corneal edema, accounting for 40%, which is related to unskilled operation technique, excessive ultrasound energy and too long emulsification time. Anterior chamber emulsification of the lens nucleus, anterior chamber surging, shallow anterior chamber of the corneal endothelial damage head, is the cause of severe corneal edema. Conclusions Continuous circular capsulorhexis and phacoemulsification nuclei are the key to emulsification. Our data show that as long as we have mastered the extracapsular removal technique and earnestly learn the theoretical knowledge of phacoemulsification, after careful training and practice, we can reduce complications and master the phacoemulsification technology faster.