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Small incision cataract phacoemulsification and intraocular lens implantation clinical results


in the past 10 years, the rapid development of cataract surgical techniques. Constantly updated surgical equipment, surgical methods are constantly improving, cataract law will become the standard method is almost the only developed the surgical method used. Unable to purchase milk for the equipment over the hospital, an ophthalmologist can only feel powerless and frustrated, and no suture phacoemulsification cataract surgery, because it is simple to learn, no special equipment, surgical, low cost, fewer complications, surgical results with ultrasound comparable emulsion, etc., and gradually by the majority of primary eye doctors of all ages. Therefore, our hospital in 2003 to 2005 using the treatment of various types of cataract, 25 cases achieved good surgical results, are summarized data reported as follows. 1 Materials and Methods 1.1 General information on the 25 patients with cataract, 25, 14 males and 14, and 11 females, 11. Age 51 to 79 years, mean 62 years, cataract lens nuclear hardness grade Ⅲ ~ Ⅴ. Exclude this group of patients before surgery associated with other eye diseases and suitable for surgery patients. 1.2 equipment and instruments produced in Suzhou T-3 type ophthalmic surgical microscope, the love of Victoria Department of viscoelastic sodium hyaluronate and sodium hyaluronate,mbt chaussures paris, intraocular lens for the American-OII hard crystals. 1.3 surgical methods according to routine cataract surgery, preoperative preparation, starting 1h before surgery drops mydriatic, fully dilated, the line retrobulbar anesthesia or peribulbar anesthesia. Hang rectus suture, cut above the basement vault of the conjunctival flap, just above the limbus in the Department for a length of about 6mm 2mm anti-eyebrow lamellar scleral incision, a thickness of 1 / 2 scleral layer. Lamellar separation with scleral tunnel knife to 2mm inside the limbus at the transparent cornea, the microkeratome to Jian Ren puncture into the anterior chamber. Anterior chamber injection of viscoelastic in the crystal surface with the capsulotomy needle or tweezers curvilinear capsulorhexis capsule diameter of about 6mm, the balance of fluid line into the water separation, the nuclear free from the cortex of bed and into the anterior chamber. Between the nuclear and the corneal endothelium and between nuclear and posterior capsule were injected viscoelastic. Crystals with water below the snare into the nuclear, water and light pressure gently to the posterior lip of the incision into the tunnel incision and remove the nuclear crystal nucleus. Net absorption cortex, the anterior chamber re-injection of viscoelastic, intraocular lens implantation, injection of 0.1%, Kami-lam, miosis, and then rinse the anterior chamber,ralph lauren pas cher, the incision, as the case may be surgery suture needle or suture, subconjunctival gentamicin 20 000 u + Dexamethasone 2mg, conjunctival sac coated compound tobramycin ointment, bandage the eye surgery. 2 results 2.1 visual acuity of 25 cases of 25 after 1 week,sac hermes birkin, 1m and 3m vision has greatly improved, including visual acuity after 1 week 0.5 93%, more than 0.8 accounted for 7%, 1m visual acuity of 0.8 (50%) more than 1.0 accounted for 50%, 3m visual acuity of 0.8 accounted for 15% to 85% above 1.0. 2.2 post-operative complications (1) corneal edema: generally around the incision, occurred at postoperative day 1, day 3 disappeared. Two cases of severe corneal edema, recombinant human epidermal growth factor (gold for Shu), eye surgery recovery, hyphema,ralph lauren paris, postoperative day 1 1 case, after absorption. (2) eye response: 24 cases of anterior chamber to form a good, no obvious reaction. 1 case of iris incarceration in the incision line of the anterior chamber angioplasty, a needle and suture the incision after 1 week recovery. Postoperative astigmatism, postoperative astigmatism of 1 month average 1.25 ± D, basically unchanged after 3 months. 3 discussions described in this article small incision phacoemulsification cataract surgery is extracapsular cataract extraction surgery on further improvements. The outstanding advantage of the tunnel from the incision closed, due to the distance between the inside and outside the incision of about 4mm, the intraocular pressure enough to make the wound automatically closed as and anti-eyebrow-shaped incision corners of traction, can not maintain the duo cut open. Operation, the anterior chamber stability, easier to aspirate the cortex, reducing intraoperative and postoperative complications. Reduce the corneal incision without suture induced astigmatism, visual acuity better [2]. The operation of the key steps: (1) preoperative, intraoperative fully dilated, mydriatic drops 1h before surgery, if preoperative dilation 2 ~ 3h began to surgery efficacy will gradually disappear, even if re-Dropping, dilation effect is not obvious. Dropping a few minutes before surgery if there is no sufficient time for the medicine to take effect. In addition to the inculcation of the surgical solution by adding epinephrine (500ml balanced solution +0.3 ml 1:1000 adrenaline) to help maintain a dilated. (2) incision: scleral flap approximately 1 / 2 the thickness of the sclera can be. Sclera separation too deep, prematurely into the anterior chamber angle at the front into the anterior chamber, iris prolapse lead, wound dehiscence affect subsequent operations. Separation is too shallow will sclera scleral flap is too thin, deformation, poor wound from closing. Corneal knife sharp enough to avoid damage to the cornea into the anterior chamber or Descemet folds. Puncture into the anterior chamber when the chamber is not shallow. In case of Descemet detachment at the end of surgery, the anterior chamber into a bubble, can re-attached after the elastic layer, after a mistake from the elastic layer and endothelial removal can lead to irreversible corneal endothelial decompensation. (3) full of water separation. Loose capsule - the cortex - the link between the nucleus, the central part of the hard-core as smaller and separated from the capsular bag to the anterior chamber. Water in the capsule, the capsule and cortex detachable - capsule separation. Water in between cortical and nuclear, immature nuclear cataracts in the adult golden halo around the formation, cortex and nucleus can be separated - layer separation, capsule separation is more important. (4) remove the core, the smaller nuclear easily removed, for approval to move a large trapezoidal tunnel incision from the side hole to move into the viscoelastic room to increase the space and the anterior chamber pressure, and kernel into the incision, you can easily use the capsulotomy needle hook from the side of the core trimming the top edge spin extraction. For over cooked and the large hard-core need to expand the incision was delivered. Must not operate the front room too much, or vulnerable to the suspensory ligament injury and corneal endothelium. Postoperative complications of corneal edema, shallow anterior chamber, residual cortical lens, corneal astigmatism, complications affecting the recovery of visual acuity, but if a skilled master the surgical techniques, these complications are often avoided .
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