超声乳化白内障摘除手术中小瞳孔的处理

目的探讨小瞳孔白内障的手术方法、效果、并发症及其处理.方法本组对近5年来完成的188例由于炎症、抗青光眼手术以后、外伤、糖尿病等引起的小瞳孔白内障病人进行回顾性分析.本组病人均采用超声乳化摘除法,手术中没有用辅助的扩瞳器,采用的是人工机械性扩大瞳孔,超声乳化的技巧是弹性法和劈裂法.结果手术后病人的瞳孔都有不同程度的扩大,但一般都不大于5mm且成规则状.有半数病人有不同程度的手术后角膜水肿,1周后自行恢复;极个别的病人角膜水肿恢复时间比较长,但未发现角膜失代偿.还有少数病人有后囊破裂,悬韧带断裂,玻璃体脱出.结论对于有经验的医师超声乳化手术在小瞳孔白内障的处理是安全有效的,可以获得如同正常瞳孔的白内障相同的效果.

Phacoemulsification in small pupil cataract

Objective To investigate the surgical methods ,results, complications and management in small pupil cataract. Methods One hundred and eighty-eight small pupil cataract patients who had had phacoemulsification were followed up for 2months to 5 years. The small pupils were dilated manually , but not by special instrument . Results After surgery the pupil in this group became bigger in a good round shape ,and not too big . Corneal edema could be found in half of the patients, mostly clear up in one week . Only a small amount of patients spend a longer period to recover.Conclusion Small pupil is challenging in cataract surgery, is contraindication to new surgeons ,but not to experienced surgeons.