手法小切口无缝线白内障摘出术  

Manual small incision sutureless cataract surgery.

作　　者：张磊[1] 柳林[1] 

机构地区：[1]第二军医大学附属长海医院眼科,上海200433

出　　处：《眼外伤职业眼病杂志》2006年第5期346-348,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的比较手法小切口白内障手术(MSICS),常规白内障囊外摘出术(ECCE)和晶状体超声乳化术(Phacoe)3种手术方法的效果。方法191例210眼老年性白内障随机分成3组,每组70眼,分别采用MSICS,ECCE,Phacoe手术方法,均一期植入硬质人工晶状体。就其术后1周视力、手术源性散光、主要手术并发症及手术成本进行比较。结果术后1周裸眼视力≥0.6者,MSICS组多于ECCE组,差异有统计学意义(P<0.05);MSICS组与Phacoe组比较,差异无统计学意义(P>0.05)。术后1周计算手术源性散光,MSICS组低于ECCE组,P<0.05;MSICS组与Phacoe组比较,P>0.05。术中后囊破裂合并玻璃体脱出:MSICS组4眼,ECCE组3眼,Phacoe组3眼。术后第1天角膜明显水肿:MSICS组5眼,ECCE组3眼,Phacoe组5眼。MSICS组与ECCE组手术成本相似,MSICS组手术成本明显低于Phacoe组。结论MSICS疗效优于ECCE,手术成本与ECCE相当。MSICS疗效与Phacoe相比无明显差异,手术成本明显低于Phacoe。MSICS兼备了ECCE的成本优势与Phacoe的效果优势,应为大规模治疗白内障盲的重要手段。Objective To compare the efficacy and surgical cost after cataract surgery by manual small incision sutureless cataract surgery （MSICS）, conventional extracapsular cataract extraction （ECCE） and phacoemulsification（Phacoe）. Methods 210 eyes of cataract were randomized to undergo MSICS, ECCE and Phacoe with intraocular lens （ non -foldable） implanation. The visual acuity, surgically induced astigmatism, complications and the operative cost were recorded and compared after surgery. Results The postoperative visual acuity was checked one week after operation. For better uncorrected visual acuity （ ≥ 0.6 ）, there was significant statistic difference between MSICS group and ECCE group, but there was no significant difference between MSICS group and Phacoe group. For poorer uncorrected visual acuity （40.3）, there was no significant difference between these three group. The surgically induced astigmatism was calculated one week after surgery. There was significant statistic difference between MSICS group and ECCE group, but there was no significant difference between MSICS group and Phacoe group. During surgery, posterior capsular ruptured and vitreous came out in 4 eyes （5.71%） in MSICS group, 3 eyes （4.29%） in ECCE group and 3 eyes （4.29%） in Phacoe group, Moderate corneal edema happened in 5 eyes （7.14% ） in MSICS group,3 eyes （4.29%） in ECCE group and 5 eyes （7.14% ） in Phacoe group. The operative cost of MSICS is similar to ECCE, but much less than Phacoe. Conclusions MSICS is effective and economical which is the most suitable surgical method for rural and basic hospital.

关 键 词：小切口 白内障囊外摘出术 超声乳化吸出术 疗效 

分 类 号：R779.66[医药卫生—眼科]