Mandal A K
VST Centre for Glaucoma Care, L.V. Prasad Eye Institute, Hyderabad, India.
J Cataract Refract Surg. 1996 Apr;22(3):288-93. doi: 10.1016/s0886-3350(96)80237-9.
Performing endocapsular surgery can be more difficult in eyes with phacolytic glaucoma because the capsule is fragile and zonules are weak. In this study, I investigated the safety and efficacy of a technique for performing endocapsular surgery with and without posterior chamber intraocular lens (IOL) implantation in 19 eyes of 19 patients with phacolytic glaucoma. This technique involves aspiration of the fluid cortex from the capsular bag using a 26 gauge bent needle. After anterior capsulotomy with angled Vannas scissors, the nucleus is delivered using minimal pressure on the irrigating vectis. The remaining cortex is completely removed using minimal irrigating fluid. At the end of the procedure, a posterior chamber IOL is inserted in the bag as indicated. A V-shaped anterior capsulectomy is completed using Vannas scissors, without exerting traction on the zonules. Intraoperatively, internal structures can be clearly visualized and the entire procedure performed with minimal trauma to the fragile lens capsule and zonular apparatus. I encountered no major complications. Follow-up ranged from 12 to 36 months with satisfactory visual outcome and good intraocular pressure control without antiglaucoma medication in all patients.
对于晶状体溶解性青光眼患者的眼睛，进行囊内手术可能会更加困难，因为晶状体囊膜脆弱且悬韧带薄弱。在本研究中，我调查了一种在19例晶状体溶解性青光眼患者的19只眼中进行囊内手术并植入或不植入后房型人工晶状体（IOL）的技术的安全性和有效性。该技术包括使用26号弯针从晶状体囊袋中吸出皮质液体。用有角度的Vannas剪刀进行前囊切开术后，在冲洗式晶状体钩上施加最小压力娩出晶状体核。使用最少的冲洗液完全清除剩余的皮质。在手术结束时，根据情况将后房型IOL植入囊袋内。使用Vannas剪刀完成V形前囊切除术，不对悬韧带施加牵引力。术中，内部结构可清晰可视化，整个手术过程对脆弱的晶状体囊膜和悬韧带装置造成的创伤最小。我未遇到重大并发症。随访时间为12至36个月，所有患者的视力结果令人满意，眼压得到良好控制，无需使用抗青光眼药物。
