Yokokura Shunji, Hariya Takehiro, Uematsu Megumi, Meguro Yasuhiko, Kobayashi Wataru, Nishida Kohji, Nakazawa Toru
*Department of Ophthalmology, Tohoku Graduate School of Medicine, Sendai, Japan; and †Department of Ophthalmology, Osaka Graduate School of Medicine, Osaka University, Osaka, Japan.
Cornea. 2015 Mar;34(3):275-8. doi: 10.1097/ICO.0000000000000319.
The aim of this study was to describe a method for non-open-sky continuous curvilinear capsulorhexis (CCC) with chandelier retroillumination for penetrating keratoplasty triple procedure and report its effectiveness in decreasing intraoperative complications and enabling successful primary intraocular lens (IOL) insertion in patients with moderate or dense central corneal opacities.
Seventeen eyes of 17 patients were enrolled in this study, divided into a chandelier group, including 7 eyes of 7 patients, and a nonchandelier group, including 10 eyes of 10 patients. In each group, time to achieve CCC (in seconds), open-sky time (in seconds), and operation time (in minutes) were measured, and the rates of successful CCC completion, rupture of the posterior capsule or zonule of Zinn, and successful IOL insertion were recorded.
CCC time was not significantly different in both groups. In the chandelier group, however, open-sky time and operation time were significantly shorter than in the nonchandelier group (1429 ± 67 vs. 2016 ± 354 seconds, and 90.4 ± 3.5 vs. 108.9 ± 10.3 minutes, respectively). In the chandelier group, the rate of successful CCC completion was significantly higher than in the nonchandelier group (86% vs. 30%). The rates of posterior capsule or zonule of Zinn rupture and successful IOL insertion were not significantly different (14% vs. 40%, 14% vs. 10%, and 86% vs. 70%, respectively).
Non-open-sky CCC with chandelier illumination has many advantages for penetrating keratoplasty triple procedure compared with open-sky CCC without chandelier illumination.
本研究旨在描述一种用于穿透性角膜移植三联手术的非开放式连续环形撕囊（CCC）方法，该方法采用吊灯式后照法，并报告其在减少术中并发症以及使中度或致密中央角膜混浊患者成功植入一期人工晶状体（IOL）方面的有效性。
本研究纳入了17例患者的17只眼，分为吊灯组（7例患者的7只眼）和非吊灯组（10例患者的10只眼）。测量每组完成CCC的时间（秒）、开放式操作时间（秒）和手术时间（分钟），并记录CCC成功完成率、后囊膜或晶状体悬韧带破裂率以及IOL成功植入率。
两组的CCC时间无显著差异。然而，吊灯组的开放式操作时间和手术时间明显短于非吊灯组（分别为1429±67秒对2016±354秒，以及90.4±3.5分钟对108.9±10.3分钟）。吊灯组的CCC成功完成率显著高于非吊灯组（86%对30%）。后囊膜或晶状体悬韧带破裂率以及IOL成功植入率无显著差异（分别为14%对40%，14%对10%，以及86%对70%）。
与无吊灯照明的开放式CCC相比，吊灯照明下的非开放式CCC在穿透性角膜移植三联手术中有许多优势。
