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目的 评价对硬核 ( + / )白内障采用囊外摘除法的优点 ;探讨术中应用电凝环形撕囊后的娩核方法。方法 角膜缘外 2～ 2 .5 mm做长约 7～ 8m m巩膜隧道切口 ,行电凝连续环形撕囊直径约 6～ 7mm,用自制晶状体圈及自制晶状体核拉钩互相配合 ,将硬核拉出切口 ,囊袋内植入人工晶体。结果 116例 (116眼 )中 115眼撕囊口经娩核后仍连续完整 ,囊袋内植入人工晶体 ,术后第 1天 116眼角膜全部透明 ,瞳孔圆 ,光反应正常。术后 1周裸眼视力≥ 0 .5者 10 3眼占 88.8%。结论 对于硬核白内障 ,囊外摘除法仍有意义 ;电凝环形撕囊克服了开罐式截囊的缺陷及手法环形撕囊对成熟期和过熟期白内障等难以完成的缺点 ,改进的娩核方法保持了撕囊口的平滑连续性及最大限度减少与角膜内皮摩擦。
Objective To evaluate the advantages of extracapsular cataract extraction of hard nucleus (+ /) cataract and explore the method of delivery after electrocoagulation of the circumferential capsulorhexis. Methods The scleral tunnel incision was made from 2 to 2.5 mm beyond the limbus and was about 7 to 8 mm in length. The diameter of the continuous curled capiocervix was about 6 to 7 mm. The self-made lens ring and self-made lens nucleus were used to cooperate with each other. Out of the incision, intraocular lens implantation. Results In 116 eyes (116 eyes), 115 eyes of the capsulorhexis were still intact and the intraocular lens was implanted into the capsular bag. On the first day after surgery, 116 eyes were completely transparent with pupil circle and light reaction. One week after operation, uncorrected visual acuity ≥0.5 was 88.8% in 103 eyes. Conclusions For extracapsular cataract, the extracapsular excision method is still meaningful. The electrocoagulation of the circumferential capsulorhexis overcomes the defects of can opener-type capsulotomy and the shortcomings of the annular capsulorhexis which are difficult to be accomplished in mature and over-mature cataracts. The improved delivery The nuclear approach maintains a smooth continuity of the capsulorhexis and minimizes friction with the corneal endothelium.