刘冬梅 毕宏生等 中华眼视光学与视觉科学
【摘要】 目的 探讨2.2 mm微切口超声乳化术中置入瞳孔扩张器治疗小瞳孔白内障的安全性和有效性。方法 回顾性系列病例研究。32例（40眼）小瞳孔的白内障患者，做2.2 mm透明角膜切口后植入Graether瞳孔扩张器扩大瞳孔，然后完成超声乳化联合IOL植入术，观察术后视力、角膜水肿情况、前房反应、瞳孔变化及并发症。结果 Graether瞳孔扩张器在术中可使瞳孔直径维持在5.5~6.5 mm左右，40眼均顺利地完成了手术，术中无虹膜损伤、后囊膜破裂等并发症。术后1个月视力≥1.0者6眼（15%），0.5～0.8者22眼（55%），0.1～0.4者11眼（28%），0.05～0.08者1眼（2%）。术后随访瞳孔形状呈圆形或近圆形，均有瞳孔对光反射。结论 微切口超声乳化手术中置入瞳孔扩张器治疗小瞳孔白内障，既可以保证良好的手术视野，又可以保护虹膜组织，增加了超声乳化术的安全性，手术损伤小，术后视力恢复理想，手术并发症少。
【关键词】 超声乳化白内障吸除术； 微切口； 小瞳孔； 瞳孔扩张器
DOI：10.3760/cma.j.issn.1674-845X.2014.08.007
作者单位：250002 济南，山东眼科医院山东眼科研究所
通信作者：毕宏生，Email：hongshengbi@126.com
The outcomes of using a pupil dilator for small pupil cataract surgery with a 2.2 mm coaxial microincision
Liu Dongmei， Bi Hongsheng， Cai Wanting， Ma Xianzhen， Liu Cuihong. Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine， Eye Institute of Shandong University of Traditional Chinese Medicine， Jinan 250002， China
Corresponding author：Bi Hongsheng，Email：hongshengbi@126.com
【Abstract】 Objective To study the safety and efficacy of treatment using a pupil dilator during phacoemulsification for a small pupil cataract with a 2.2 mm coaxial microincision. Methods A total of 32 consecutive patients （40 eyes） with a small pupil cataract were enrolled in this retrospective study and underwent coaxial microincision cataract surgery using the Graether pupil dilator. Postoperative vision， corneal edema， anterior chamber reaction， pupil changes and complications were observed after surgery. Results The mean pupil size was 5.5-6.5 mm during surgery and all surgeries were completed successfully. There were no cases of iris damage or posterior capsular rupture. Visual acuity was 1.0 or better in 15% of eyes （6 eyes） at 1 month after surgery， 22 eyes （55%） were 0.5-0.8， 11 eyes （28%） were 0.1-0.4， and only 1 eye （2%） was 0.05. Pupil shape was round or approximately round and all pupils had a light reflex during the follow-up period after surgery. Conclusion The treatment for a small pupil cataract using a pupil dilator during phacoemulsification with coaxial microincision cannot only maintain a sufficient surgical field but also protect the iris， result in good postoperative vision with fewer complications， increases the safety and efficacy of phacoemulsification.
【Key words】 Phacoemulsification；Microincision；Small pupil；Pupil dilator