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使用两种眼科粘弹剂和台盼蓝染色评估膨胀期白内障手术中的术中并发症

Assessment of intraoperative complications in intumescent cataract surgery using 2 ophthalmic viscosurgical devices and trypan blue staining.

作者信息

Hengerer Fritz H, Dick H Burkhard, Kohnen Thomas, Conrad-Hengerer Ina

机构信息

From the Department of Ophthalmology (Hengerer, Kohnen), Goethe University, Frankfurt, and the Department of Ophthalmology (Dick, Conrad-Hengerer), Ruhr University, Bochum, Germany.

From the Department of Ophthalmology (Hengerer, Kohnen), Goethe University, Frankfurt, and the Department of Ophthalmology (Dick, Conrad-Hengerer), Ruhr University, Bochum, Germany.

出版信息

J Cataract Refract Surg. 2015 Apr;41(4):714-8. doi: 10.1016/j.jcrs.2014.06.039.

DOI:10.1016/j.jcrs.2014.06.039
PMID:25840295
Abstract

PURPOSE

To evaluate intraoperative complications during capsulorhexis and phacoemulsification in intumescent white cataracts using 2 ophthalmic viscosurgical device (OVD) techniques.

SETTING

Ruhr University Eye Clinic, Bochum, Germany.

DESIGN

Case series.

METHODS

Patients with eyes with intumescent white cataract were recruited and placed in 2 groups. After capsule staining using trypan blue, a central indentation of the anterior lens capsule was created in the eyes in Group 1 using a medium-viscosity OVD (Healon 1.0%) and in the eyes in Group 2 using both medium-viscosity (1.0%) and high-viscosity (2.3%) OVDs. Then a continuous curvilinear capsulorhexis (CCC) was performed. The outcomes measured were the horizontal and vertical diameters of the CCC, the deviation from the target diameter, and intraoperative complications.

RESULTS

In Group 1 (21 eyes), deviation from the target CCC diameter occurred in 12 eyes (10 oversized, 2 undersized), and in Group 2 (20 eyes) deviation occurred in 6 eyes (4 oversized, 2 undersized). In Group 1, capsule tears appeared in 2 eyes and in 1 eye, the procedure had to be converted to extracapsular cataract extraction with anterior vitrectomy. In Group 2, there were no capsule tears.

CONCLUSION

Using 2 different OVDs and placing the high-viscosity OVD centrally led to safe indentation of the anterior lens capsule and reduced the risk for CCC enlargement and capsule tear during surgery.

FINANCIAL DISCLOSURE

No author has a financial or proprietary interest in any material or method mentioned.

摘要

目的

采用两种眼科粘弹剂(OVD)技术评估膨胀期白色白内障在撕囊和超声乳化手术中的术中并发症。

背景

德国波鸿鲁尔大学眼科诊所。

设计

病例系列。

方法

招募患有膨胀期白色白内障的患者并分为两组。使用台盼蓝对晶状体囊膜染色后,第1组患者的眼睛使用中等粘度的OVD(Healon 1.0%)在前囊膜上制作中央压痕,第2组患者的眼睛使用中等粘度(1.0%)和高粘度(2.3%)的OVD制作中央压痕。然后进行连续环形撕囊(CCC)。测量的结果包括CCC的水平和垂直直径、与目标直径的偏差以及术中并发症。

结果

第1组(21只眼)中,12只眼的CCC直径与目标直径出现偏差(10只过大,2只过小),第2组(20只眼)中有6只眼出现偏差(4只过大,2只过小)。第1组中,2只眼出现囊膜撕裂,1只眼的手术不得不改为行囊外白内障摘除联合前部玻璃体切除术。第2组中未出现囊膜撕裂。

结论

使用两种不同的OVD并将高粘度OVD置于中央可实现前囊膜的安全压痕,并降低手术中CCC扩大和囊膜撕裂的风险。

财务披露

没有作者对文中提及的任何材料或方法拥有财务或专利权益。

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