吲哚菁绿运用于白色白内障超声乳化术中的临床研究

Use of indocyanine green staining technique for phacoemulsification in white cataract

摘要:

目的：探讨5g/L吲哚菁绿溶液前囊膜染色在白色白内障超声乳化术中连续环形撕囊的临床应用效果。

方法：白色白内障患者98例98眼，随机分为两组，观察组50例50眼，对照组48例48眼。对照组不做前囊膜染色。观察组采用黏弹剂下5g/L吲哚菁绿溶液前囊膜染色，前囊膜染色针抽取5g/L吲哚菁绿溶液0.1mL，自辅助切口注入到前囊膜中央表面，留置30s，平衡盐液置换出多余染料。两组均应用撕囊镊连续环形撕囊。

结果：观察组前囊膜呈现均匀的淡绿色，能见度显著提高，有48眼撕囊成功，成功率96%； 对照组有29眼撕囊成功，成功率60%，两组差异有统计学意义(P<0.05)。观察组术后裂隙灯显微镜下检查前房未见染料颗粒残存及虹膜炎及眼压升高等并发症。前房炎症反应、角膜透明度与对照组比较，差异无统计学意义。

结论：吲哚菁绿前囊膜染色使前囊清晰可辨，可提高对白色白内障患者术中撕囊的成功率，从而减少术中并发症的发生，使超声乳化白内障手术初学者较快掌握连续环形撕囊术，改善初学者的学习曲线。

Abstract:

AIM:To observe the application efficiency of 5g/L indocyanine green(ICG)staining technique for continuous circular capsulorhexis(CCC)during phacoemulsification in white cataract.

METHODS:Ninety-eight patients(98 eyes)with white cataract were randomly divided into staining group(50 cases, 50 eyes)and control group(48 cases, 48 eyes). The control group didn't do anterior capsule staining. The staining group was injected to fill the anterior chamber, 5g/L ICG 0.1mL was applied on the central surface of the anterior capsule, using a 27G blunt needle through the side-port after 30s, and the redundant ICG was replaced by BSS, and continuous curvilinear capsulorhexis was accomplished using capsulorhexis forceps.

RESULTS: In staining group: after ICG staining, the capsule, which presented uniform light green and visualization of the anterior capsule was significantly improved. There are 48 eyes capsulorhexis success. The rate of success was 96%. Meanwhile, in control group, there was 29 eyes capsulorhexis success. The rate of success was 60%. The difference was statistically significant(P<0.05). During follow-up, no dye particle and the complications of iritis or high intraocular pressure were found in the eyes of staining group. Anterior chamber inflammation, corneal opacity compared with control group, the difference was not statistically significant.

CONCLUSION:Indocyanine green staining increases the visibility of anterior capsule in over mature cataract, and it should be an effective and helpful method which can increase the success rate of capsulorehxis. At the same time, it can reduce the incidence of intraoperative complications. This will help beginners quickly grasp continuous curvilinear capsulorhexis, and shorten the learning curve.