台盼蓝作为白色白内障患者安全超声乳化手术的辅助剂
Trypan blue as an adjunct for safe phacoemulsification in eyes with white cataract.
作者信息
Jacob Soosan, Agarwal Amar, Agarwal Athiya, Agarwal Sunita, Chowdhary Saurabh, Chowdhary Reena, Bagmar Anand A
机构信息
Dr. Agarwal's Eye Hospital, Chennai, India.
出版信息
J Cataract Refract Surg. 2002 Oct;28(10):1819-25. doi: 10.1016/s0886-3350(01)01316-5.
PURPOSE
To assess the feasibility, risks, and postoperative outcomes of phacoemulsification with posterior chamber intraocular lens (PC IOL) implantation in cases of white cataract with the use of trypan blue as an adjunct for performing continuous curvilinear capsulorhexis (CCC) in the absence of a red reflex.
SETTING
Dr. Agarwal's Eye Hospital, Chennai, India.
METHODS
This prospective study comprised 52 eyes of 52 patients with white cataract that had phacoemulsification through a clear corneal temporal incision with PC IOL implantation. In all the cases, trypan blue was used under air to stain the anterior lens capsule and the karate-chop technique was used to emulsify the nucleus. The mean follow-up was 192.2 days.
RESULTS
Trypan blue adequately stained the anterior lens capsule in all cases. The CCC was completed uneventfully in 96.15% eyes; 3.85% of cases had to be converted to a conventional extraction technique because of the loss of the CCC. The mean phacoemulsification time was 2.2 minutes. Intraocular complications included incomplete capsulorhexis (3.85%) and pupillary miosis (3.80%). Postoperatively, 3 eyes (5.77%) had corneal edema (striate keratopathy) and 1 eye (1.9%) had fibrin in the anterior chamber. Five eyes (9.61%) had more than 2+ cells and flare at 2 weeks. All responded well to intensive topical and subconjunctival steroids. There were no cases of endophthalmitis. The mean central endothelial cell loss, measured in 37 eyes, was 8.5%. Of the 4 eyes (7.69%) that had increased intraocular pressure (IOP) postoperatively, all responded well to medications and the IOP was normal by the second postoperative week. Fifty eyes (96.16%) had a final best corrected visual acuity of 20/30 or better. In 2 cases, the final visual acuity was worse than 20/200 because of preexisting posterior segment pathology.
CONCLUSION
Phacoemulsification using trypan blue was safe and effective in managing white cataract and had a high success rate.
目的
评估在无红色反光情况下，使用台盼蓝辅助进行连续环形撕囊（CCC）的白色白内障病例中，白内障超声乳化联合后房型人工晶状体（PC IOL）植入术的可行性、风险及术后效果。
背景
印度钦奈阿加瓦尔眼科医院。
方法
本前瞻性研究纳入了52例患有白色白内障的患者的52只眼，通过透明角膜颞侧切口进行白内障超声乳化联合PC IOL植入。所有病例均在空气下使用台盼蓝对晶状体前囊进行染色，并采用空手道劈核技术乳化晶状体核。平均随访时间为192.2天。
结果
所有病例中台盼蓝均能充分染色晶状体前囊。96.15%的眼睛顺利完成了CCC；3.85%的病例因CCC失败而不得不改为传统摘除技术。平均超声乳化时间为2.2分钟。眼内并发症包括不完全撕囊（3.85%）和瞳孔缩小（3.80%）。术后，3只眼（5.77%）出现角膜水肿（条纹状角膜病变），1只眼（1.9%）前房出现纤维蛋白。5只眼（9.61%）在2周时出现2+以上的细胞和房水闪辉。所有患者对强化局部及结膜下类固醇治疗反应良好。无眼内炎病例。在37只眼中测量的平均中央内皮细胞损失率为8.5%。4只眼（7.69%）术后眼压升高，所有患者对药物治疗反应良好，术后第二周眼压恢复正常。50只眼（96.16%）最终最佳矫正视力达到20/30或更好。2例患者由于存在先前的后段病变，最终视力低于20/200。
结论
使用台盼蓝的白内障超声乳化术治疗白色白内障安全有效，成功率高。
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