23号与25号前囊切开镊的比较

Department of Ophthalmology, Tokai University School of Medicine, Kanagawa, Japan.

Tokai J Exp Clin Med. 2004 Sep;29(3):105-10.

In cataract surgery, the most commonly-used procedure for incision of the anterior capsule is continuous curvilinear capsulorrhexis (CCC), developed by Gimbel and Neuhann. As Gimbel has reported, CCC is a safe technique for phacoemulsification and aspiration (PEA) and intraocular lens (IOL) implantation. The optimum incision method for CCC is thought to be that of using anterior capsulotomy forceps. Recently, I have developed the side-port 23 gauge anterior capsulotomy forceps (23G forceps), manufactured by Asico, which can be manipulated via a small incision, as well as the side-port 25 gauge anterior capsulotomy forceps (25G forceps) and 25/23 gauge tapered anterior capsulotomy forceps (tapered forceps), manufactured by Inami, which are thought to provide even better ease of handling. In view of the fact that the visibility, ease of handling, bending, adverse effect on the wound, and effect on the cornea of these various forceps are important, the present comparison study among these forceps was conducted on pig lenses by means of 0.1 % trypan blue staining of the anterior capsule. It was found that capsulorrhexis was difficult with the 25G forceps because of the strong bend of the shaft. However, the tapered forceps has little bend, and like the 23G forceps, it showed outstanding handling and visibility and had little adverse effect on the wound.

在白内障手术中，用于切开前囊膜最常用的方法是连续环形撕囊术（CCC），由金贝尔和诺伊汉开发。正如金贝尔所报道的，CCC是一种用于超声乳化吸除术（PEA）和人工晶状体（IOL）植入的安全技术。人们认为CCC的最佳切开方法是使用前囊切开镊。最近，我开发了由阿西科公司生产的侧端口23号前囊切开镊（23G镊），它可以通过小切口进行操作，还有由稻美公司生产的侧端口25号前囊切开镊（25G镊）和25/23号锥形前囊切开镊（锥形镊），人们认为这些镊在操作上更加简便。鉴于这些不同镊的可视性、操作简便性、弯曲度、对伤口的不良影响以及对角膜的影响都很重要，本研究通过对猪晶状体前囊膜进行0.1%台盼蓝染色，对这些镊进行了比较研究。结果发现，25G镊由于杆部弯曲度大，撕囊困难。然而，锥形镊弯曲度小，与23G镊一样，操作和可视性出色，对伤口的不良影响小。