表麻下小切口白内障摘除IOL植入术在扶贫复明手术中的应用

Application of cataract extraction and intraocular lens implantation with small incision under topical anesthesia in poverty alleviation and cataract operations

摘要:

目的:分析和探讨在表面麻醉下行小切口白内障摘除人工晶状体植入术在扶贫复明手术中的效果。方法:在表面麻醉下对183例205眼白内障患者行小切口白内障摘除人工晶状体植入术,观察术中疼痛感、并发症、手术时间及术后视力。结果:手术过程中患者无痛感,能很好地配合手术,眼球固视好189眼(92.2%);术中偶感有轻度疼痛或异物感,可忍受并能配合手术顺利完成,或加滴表面麻醉药后能顺利完成手术者16眼(7.8%);183例205眼平均手术时间22±7min;术中及术后各种并发症的发生率均很低。术后1d视力:裸眼视力≤0.1者13眼(6.3%);0.12～0.3者47眼(22.9%);0.4～0.8者126眼(61.5%);≥0.8者19眼(9.3%),术后1wk复查视力,视力≤0.1者4眼(2.0%);0.12～0.3者23眼(11.2%);0.4～0.8者145眼(70.7%);≥0.8者33眼(16.1%)。结论:表面麻醉下小切口白内障囊外摘除人工晶状体植入术避免了相应的并发症,手术时间明显缩短,手术质量较好,因而适宜于大规模复明行动及基层医院开展以白内障为主的防盲治盲工作。

Abstract:

·AIM:To analyse and discuss the effect of cataract extraction and intraocular lens implantation with small incision under topical anesthesia in poverty alleviation and cataract operations.·METHODS:A total of 183 cases 205 eyes with cataract were operated with cataract extraction and intraocular lens implantation with small incision under topical anesthesia.Their pain during the surgery,complications and their vision after the operation were observed.·RESULTS:The patients didn’t feel painful during the operation and cooperated well.There were 189 eyes 92.2% with good eyeball fixations 16 eyes(7.8%)with occasionally little pain or foreign body sensation of bearable level to cooperate the operation favorably,or need topical anesthetic to finish the operation;The mean operation time was 22±7 minutes;and the incidence rates of complications during and after the operation were both low.On 1 day after operation,the naked vision was≤0.1 in 13 eyes(6.3%);0.12-0.3 in 47 eyes(22.9%);0.4-0.8 in 126 eyes(61.5%);≥0.8 in 19 eyes(9.3%).Rechecked in 1 week after the operation,the vision was≤0.1 in 4 eyes(2.0%);0.12-0.3 in 23 eyes(11.2%);0.4-0.8 in 145 eyes(70.7%);≥0.8 in 33 eyes(16.1%).·CONCLUSION:The cataract extraction and intraocular lens implantation with small incision under superficial anesthesia can avoid homologous complications,reduce the operation time obviously and ensure better quality of operation.It’s suitable for large-scale cataract operation actions and primary hospital to carry out the prevention and treatment of blindness in people with cataract.·