Ein-Tal Eye Center, 15 Habarzel St, 6971021, Tel Aviv, Israel.
Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel.
Int Ophthalmol. 2024 Sep 5;44(1):366. doi: 10.1007/s10792-024-03286-4.
To present our clinical experience using femtosecond laser-assisted cataract surgery (FLACS) and cortical cleavage hydrodissection in eyes with posterior polar cataract.
Medical records of consecutive10 eyes of 6 patients with clinical diagnosis of posterior polar cataract (PPC), were retrospectively reviewed. All surgeries were done by using femtosecond laser-assisted cataract surgery. In all cases careful hydrodissection was done to separate the lens material from the posterior capsule.
There were 3 males and 3 females, ages 39-73 years (average 52.5 years), two of them were implanted with toric lenses. In all eyes hydrodissection was successfully performed and the lens material was separated from the lens capsule. The posterior capsule remained intact during nucleus removal in all cases. In one eye the posterior capsule broke during cortical cleaning and the tear was converted to posterior capsulorhexis (PCCC). No postoperative complications were recorded during follow-up in all eyes.
Hydrodissection can be safely performed in combination (but not exclusively) with FLACS, in eyes with posterior polar cataract with no evidence of a preexisting posterior capsule rent. Hydrodissection is regarded by most surgeons as contraindicated in these eyes however apparently it is more gentile to the capsule than any other surgical maneuver and allows clean and efficient separation of the lens material from the thinned posterior capsule. Femtosecond laser capsulotomy and lens fragmentation is effective and may further assist surgery by pneumo-separation of the lens material. Anterior chamber maintainer may further aid to the stability of the chamber and safety of surgery.
介绍我们使用飞秒激光辅助白内障手术（FLACS）和皮质松解水分离治疗后极性白内障的临床经验。
回顾性分析了 6 例临床诊断为后极性白内障（PPC）的 10 只眼连续病例的病历。所有手术均采用飞秒激光辅助白内障手术完成。在所有病例中，均仔细进行水分离以将晶状体物质与后囊分开。
男性 3 例，女性 3 例，年龄 39-73 岁（平均 52.5 岁），其中 2 例植入了散光晶状体。在所有眼中，水分离均成功完成，晶状体物质与晶状体囊分离。在所有病例中，在核切除过程中后囊均保持完整。在一只眼中，在后皮质清洁过程中后囊破裂，该撕裂口转换为后囊膜切开术（PCCC）。在所有随访的眼中均未记录到术后并发症。
在没有先前存在的后囊膜裂的情况下，水分离可以与飞秒激光辅助白内障手术安全地联合使用（但并非专门用于）治疗后极性白内障。然而，大多数外科医生认为水分离在这些眼中是禁忌的，但实际上它比任何其他手术操作对囊膜更温和，并且允许将晶状体物质从变薄的后囊干净有效地分离。飞秒激光囊膜切开术和晶状体碎裂术是有效的，并且可以通过气动分离晶状体物质进一步辅助手术。前房维持器可以进一步帮助稳定前房和手术安全。
