关键词: 白内障/外科学, 小瞳孔, 虹膜拉钩, 虹膜切开

Abstract:

Objective To observe and compare the complications and vision of iris retractor and radial pupil iris incision in small pupil cataract surgery. Design Retrospective comparative case series. Participants Patients presented during April 2012 to June 2015 in Guangzhou Hospital of Integrated Traditional and Western Medicine accepted ultrasonic phacoemulsification combined with intraocular lens implantation for the treatment of 83 cases (90 eyes) of cataract patients. Methods 50 eyes of iris retractor in research group and 40 eyes of radial pupil iris incision in control group. The perioperative parameters, postoperative complications and visual acuity of two groups were recorded. Main Outcome Measures Ultrasound emulsification time, operation time, intraoperative and postoperative complications and postoperative visual acuity. Results The average time of phacoemulsification in control group was significantly higher than that in research group (104.8±17.9 s versus 57.8±11.9 s) (t=12.835, P<0.001). The control group average operation time was significantly lower than the research group (20.1±3.8 min versus 29.2±5.8 min) (t=-6.468, P<0.001). The patients in the control group, the rate of iris bite bleeding was significantly higher than that of study group (P<0.001). At post-operative 1-day, the proportion of corrected visual acuity better than 0.3 in the control group was 40%, significantly lower than 72% in the research group (χ2=9.328, P=0.002). At post-operative 3-month, in the control group the proportion of corrected visual acuity better than 0.3 was 80%, lower than 90% in the research group, but the difference was not statistically significant (χ2=1.798, P=0.18).  In the research group, at post-operative 1 day, pupil deformation rate was significantly lower than the control group (68% and 95%) (χ2=10.125, P=0.001)； and at 1 week, the pupil deformation rate was significantly lower than the control group (20% and 90%) (χ2=46.557, P<0.001). The research group and control group of patients with corneal edema rate were 86% and 90% respectively, the difference was not statistically significant (χ2=0.331, P=0.565). The anterior chamber reaction rate was 68% in the study group, significantly lower than the control group 95% (χ2=10.125, P=0.001). Conclusions Iris retractor in small pupil cataract surgery can enlarge pupil, and has advantages such as safe, less bleeding and less inflammation. It has positive significance on morphological and functional recovery of the pupil, is worth popularizing in clinical use. (Ophthalmol CHN, 2017, 26: 85-89)
 

Key words: cataract/surgery, small pupil, iris retractor, iris incision