Gimbel H V
Gimbel Eye Centre, Calgary.
Can J Ophthalmol. 1992 Apr;27(3):115-9.
A small pupil is an added risk with any technique for cataract extraction. A prospective study involving 1880 consecutive cataract procedures performed by one surgeon between January and June 1990 was carried out to determine the incidence of small pupils (preoperative diameter of 4 mm or less) and the surgical risk with phacoemulsification and implantation of an intraocular lens (IOL) "in the bag." Thirty eyes (1.6%) were found to have a small pupil. All 30 eyes received an in-the-bag posterior chamber IOL, with no intraoperative complications such as anterior or posterior capsule tears. The need for iris-enlarging surgery was correlated with pupil size: such surgery was done in O of the 10 eyes with pupils measuring 4 mm, 1 of the 12 eyes with pupils measuring 3 to 3.5 mm and 4 of the 8 eyes with pupils measuring 2 to 2.5 mm. The author proposes that opening the capsule with a continuous tear and removing the cataract by means of phacoemulsification with nuclear fracturing (nucleofractis) constitutes safe, efficient surgical management of eyes with small pupils undergoing cataract extraction.
任何白内障摘除技术中，小瞳孔都是一个额外的风险因素。1990年1月至6月间，一位外科医生对1880例连续进行的白内障手术开展了一项前瞻性研究，以确定小瞳孔（术前直径4毫米或更小）的发生率以及白内障超声乳化吸除联合眼内晶状体（IOL）“囊袋内”植入术的手术风险。发现有30只眼（1.6%）存在小瞳孔。所有30只眼均植入了囊袋内后房型IOL，术中未出现诸如前囊或后囊撕裂等并发症。虹膜扩大手术的必要性与瞳孔大小相关：在10只瞳孔直径为4毫米的眼中，0只眼进行了此类手术；在12只瞳孔直径为3至3.5毫米的眼中，1只眼进行了手术；在8只瞳孔直径为2至2.5毫米的眼中，4只眼进行了手术。作者提出，采用连续环形撕囊并通过碎核超声乳化术（核碎裂）摘除白内障，是小瞳孔白内障摘除术安全、有效的手术方式。
