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现代白内障囊外摘除及人工晶体植入术,近10年在发达国家广泛采用。二年来我们学习国外先进技术,采用cilco公司,AOC公司的Shearing后房型和前房型人工晶体,成功地为100例(117眼)白内障患者作了这种手术。其中106只眼为老年性白内障,6眼为并发性白内障,5眼为外伤性白内障。年龄最小29岁,最大80岁。年均62岁。后房型89眼(12～21D),前房型28眼(14～19D)。一期植入114眼,二期植入3跟。随访时间为1～19个月,平均4.7月。本组117眼中随访资料完整者101只眼,术后最佳矫正视力达到0.5以上者89眼(88%),前房型为77.8%,后房型为91.4%视力达到1.0以上者,后房型82只眼中有54眼(65.8%)前房型18眼中有3眼(17.2%)。视力低于0.5的病例中,术前已有明确眼病史者7眼(视神经萎缩3眼,角膜斑翳2眼,陈旧性黄斑病变2眼)。若除去这些病例,则95%病人获得了0.5以上的视力。本文着重介绍了现代囊外摘除术及人工晶体植入术适应症,术前准备、手术要点。重点讨论了熟练掌握显微器械及手术显微镜,是完成手术必需的基础训练;充分的降压及完全的麻醉是手术顺利进行的关键;充分的截除前囊膜及冲洗吸出晶体核和皮质,保持良好的前房、保留完整的后囊膜,是人工晶体植入术几大要点;能否正确及时地处理术中和术后并发症极大地影响着术后视功能恢复。
Modern extracapsular cataract extraction and intraocular lens implantation, nearly 10 years widely used in developed countries. In the past two years, we have studied advanced foreign technologies and successfully performed surgery on 100 cases (117 eyes) of cataract patients using CIELA, AOC Shearing posterior chamber and anterior chamber intraocular lens. Among them, 106 eyes were senile cataract, 6 eyes were complicated cataract, and 5 eyes were traumatic cataract. Youngest 29 years old, maximum 80 years old. Average 62 years old. 89 posterior chamber type (12 ~ 21D), anterior chamber type 28 (14 ~ 19D). The first stage was implanted in 114 eyes and the second stage was implanted in 3 eyes. Follow-up time was 1 to 19 months, an average of 4.7 months. The group of 117 eyes with complete follow-up data 101 eyes, postoperative best corrected visual acuity of 0.5 or more in 89 eyes (88%), anterior chamber type was 77.8%, posterior chamber type was 91.4% visual acuity of 1.0 or more, posterior chamber type 82 54 eyes (65.8%) in the eyes and 3 eyes (17.2%) in 18 eyes of the anterior chamber. Among cases of visual acuity lower than 0.5, there were 7 eyes with clear history of ophthalmopathy before surgery (3 eyes with optic atrophy, 2 eyes with corneal canthus, 2 eyes with old macular degeneration). If these cases were removed, 95% of the patients had more than 0.5 eyesight. This article highlights modern extracapsular cataract extraction and intraocular lens implantation indications, preoperative preparation, the main points of surgery. Focusing on the master of the microscope and surgical microscope, is the basic training necessary for the completion of surgery; adequate decompression and complete anesthesia is the key to the smooth operation of the surgery; adequate removal of the anterior capsule and flushing out the crystal nucleus and cortex, Maintain a good anterior chamber, retaining the integrity of the posterior capsule, is the main points of intraocular lens implantation; can correct and timely treatment of intraoperative and postoperative complications greatly affect postoperative visual function recovery.