Susić Nikola, Brajković Jasenka, Susić Edita, Kalauz-Surać Ivana
Department of Ophthalmology, Sibenik General Hospital, Sibenik, Croatia.
Acta Clin Croat. 2010 Sep;49(3):343-5.
Phacoemulsification of white cataracts is associated with some difficulties and a higher rate of intraoperative complications. The aim of this report is to describe one of these cases and the possible ways to manage them. We report on cataract surgery in a 79-year-old patient with white mature cataract and insufficient mydriasis because of the pseudoexfoliation syndrome. The use of vital dyes for staining the anterior capsule enhances visualization and helps perform continuous curvilinear capsulorrhexis, which is a key point for performing successful phacoemulsification. In case of small pupils because of insufficient pharmacological mydriasis, we can either enlarge the pupil or work through it. Meticulous preoperative biomicroscopic and A-scan examination (the type of cataract according to intralental A-scan findings) can help select appropriate phaco technique. Despite a higher rate ofintraoperative complications, white cataracts can be safely operated on with phacoemulsification technique.
白色白内障的超声乳化手术存在一些困难且术中并发症发生率较高。本报告的目的是描述其中一例病例以及处理这些问题的可能方法。我们报告了一例79岁患有白色成熟白内障且因假性剥脱综合征导致瞳孔散大不足的患者的白内障手术。使用活性染料对前囊膜进行染色可增强可视化效果，并有助于进行连续环形撕囊，这是成功进行超声乳化手术的关键步骤。在因药物性散瞳不足导致瞳孔较小时，我们既可以扩大瞳孔，也可以在小瞳孔状态下进行手术。细致的术前生物显微镜检查和A超检查（根据晶状体内部A超检查结果判断白内障类型）有助于选择合适的超声乳化技术。尽管术中并发症发生率较高，但白色白内障采用超声乳化技术仍可安全进行手术。
