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目的:探讨后极性白内障的临床特点及超声乳化手术的手术技巧。方法:连续收集2009-10/2011-03在本院诊治的后极性白内障患者12例17眼,所有病例均接受详尽的病史采集,以及视力、裂隙灯显微镜检查,B型超声波及间接检眼镜检查,所有患眼在球周浸润麻醉下行超声乳化白内障摘除及折叠人工晶状体植入,总结手术技巧、术前术后视力及术中并发症。结果:所有患眼均植入折叠人工晶状体。术中11眼后囊膜完整透明,2眼后囊膜破裂,其中1眼发生在分核时,另1眼发生在核周壳吸除时;4眼术中发现后囊膜混浊需后期行YAG激光后囊膜切开术。15眼折叠人工晶状体植入囊袋内,2眼植入睫状沟。术后1mo最佳矫正视力≥0.5者16眼,0.4者1眼。结论:超声乳化联合折叠型人工晶状体植入是治疗后极性白内障安全有效的方法。应用连续环形撕囊、轻柔谨慎的水分层而不做水分离,低能量、低吸力、低流量的超声乳化参数设置,手动吸除核周壳和皮质等手术技巧,可以减少手术并发症。
Objective: To investigate the clinical features of posterior polar cataract and surgical techniques of phacoemulsification. Methods: A total of 12 cases (17 eyes) of posterior polar cataract who were diagnosed and treated in our hospital from October 2009 to March 2011 were enrolled in this study. All patients underwent detailed medical history collection, visual acuity, slit lamp microscopy, B ultrasound and indirect ophthalmoscope All eyes underwent peri-balloon anesthesia with phacoemulsification and foldable intraocular lens implantation. The surgical techniques, preoperative and postoperative visual acuity and intraoperative complications were summarized. RESULTS: Folding intraocular lenses were implanted in all affected eyes. Intraoperative 11 cases of complete and transparent after the capsule, 2 after the rupture of the capsular bag, including 1 in the nuclear sub-nuclear, while the other occurred in the nuclear perinuclear aspiration; 4 ophthalmocele posterior capsule opacity required post-operative YAG laser posterior capsulotomy. 15 eyes folded intraocular lens implantation, 2 eyes implanted ciliary sulcus. After 1mo the best corrected visual acuity ≥ 0.5 in 16 eyes, 0.4 in 1 eye. Conclusion: Phacoemulsification combined with foldable intraocular lens implantation is a safe and effective method for the treatment of post-polar cataract. Application of continuous circular capsulorhexis, cautious water layer without water separation, low energy, low suction, low flow phacoemulsification parameter settings, manual removal of the perinuclear shell and cortex and other surgical techniques, can reduce the surgical complications.