【摘要】  　　目的：探讨前后夹击双向劈核法在硬核白内障超声乳化手术中的应用效果。方法：对219例(271眼)级以上硬核白内障采取前后夹击劈核法，经充分水分离和水分层，吸除硬核前的皮质及软核后，乳化头退至前囊口上缘，劈核器轻压核下方，停止灌注让核上缘随前房变浅脱出囊袋口，乳化头顺势抵住核上缘，灌注加深前房后，乳化头滑入核后面，劈核器置核前面，前后夹击将核劈碎乳化吸出。结果：271眼硬核都被顺利击碎，平均乳化时间为57.4s，术后1d视力≥0.3者249眼（91.9％），术后1mo视力≥0.5者235眼（86.7％），≥1.0者96眼（35.4％）。 结论：硬核白内障超声乳化手术中双向劈核法碎核彻底、操作简便、安全有效，为粉碎硬核的一种好方法。

【关键词】  白内障　硬核　超声乳化　劈核技术

　　Application of anteroposterior interceptive chop in phacoemulsification for hard nucleus cataract

    Bo Gao, Zhu Yuan, Yi-Zhuan Zhang

    Department of Ophthalmology, the Affiliated Hospital, Wuhan University of Science and Technology, Wuhan 430064, Hubei Province, China

    AbstractAIM:To evaluate the effect of anteroposterior interceptive chop in phacoemulsification for hard nucleus cataract.METHODS:Two hundred and seventy-one eyes of 219 patients with hard nucleus cataract, grading level IV or V, were operated with anteroposterior interceptive chop method for splitting the nucleus, and then with phacoemulsification. RESULTS:The hard nucleus of the 271 eyes were successfully routed. The average phaco time was 57.4 s. Postoperatively, the number of patients with visual acuity ≥0.3 was 91.9% at postoperative 1 day, ≥0.5 in 86.7% patients and ≥1.0 in 35.4% patients at postoperative 1 month.CONCLUSION:Anteroposterior interceptive chop for splitting nucleus in phacoemulsification is an effective, convenient and safe method to operate on hard nucleus cataract.

    · KEYWORDS:cataract; hard nucleus; phacoemulsification; anteroposterior interceptive chop

　　0引言

    因为国情国人白内障患者往往待其完全成熟后才进行治疗，尤其在中小城市和乡村等卫生条件相对落后的地区，因此硬核白内障占了相当的比例。白内障超声乳化手术中，为了减少对硬核的超声乳化能量和时间，各种碎核方法[1-3]应运而生。例如拦截劈核法[4]以及横向劈核法[5]，挤切劈核法等[6]，各有其优势，但都有其共同的缺点，即在囊袋内劈核易损伤囊袋，硬核底部不易劈开，出现藕断丝连的现象[4]。因此，我们在临床中探讨前后夹击双向劈核来处理超声乳化中的硬核白内障，经临床验证该方法操作简便、碎核彻底、并发症少，并尽可能地节省了超声乳化的能量及时间，为又一碎核的好方法。

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