无缝线小切口白内障囊外摘出术在硬核白内障中的应用  

Clinical observation of hard nuclear cataract with small incision extracapsular cataract extraction

作　　者：李仁芳 

机构地区：[1]广东省河源市人民医院眼科,517000

出　　处：《眼科新进展》2009年第1期49-50,53,共3页Recent Advances in Ophthalmology

摘　　要：目的观察无缝线小切口白内障囊外摘出联合人工晶状体植入术治疗硬核白内障的疗效。方法观察2组共299例312眼Ⅲ级以上硬核白内障患者,分别应用无缝线小切口白内障囊外摘出联合人工晶状体植入术(小切口组,161眼)和常规超声乳化白内障吸出联合人工晶状体植入术(超乳组,151眼),分别比较手术时间、术后视力、角膜内皮细胞丢失率、术后散光及其他相关并发症发生的差异。结果手术时间:小切口组平均(691±89)s,超乳组平均(663±97)s,2组比较差异无统计学意义(P>0.05)。术后第1天视力≥0.5者小切口组为142眼,超乳组112眼,2组相比差异有统计学意义(P<0.05);术后1个月视力≥0.5者小切口组150眼,超乳组140眼,2组相比差异无统计学意义(χ2=0.024,P>0.05)。角膜内皮细胞丢失率:术后第1天小切口组(10.03±2.87)%,超乳组(18.31±3.34)%;术后1个月小切口组(8.51±2.62)%,超乳组(16.11±3.76)%;2组相比差异均有统计学意义(P<0.05)。术后散光(>1.0DC):小切口组25.47%,超乳组17.22%;角膜水肿:小切口组9.32%,超乳组17.22%,2组比较差异均有统计学意义(P<0.05)。虹膜脱出、后囊膜破裂、切口渗漏等并发症差异无统计学意义。结论对于Ⅲ级以上硬核白内障,无缝线小切口白内障囊外摘出联合人工晶状体植入术是一种较好的治疗选择,值得基层推广。Objective To observe the efficacy of small incision cataract extraction with seamless line and intraocular lens implantation in the treatment of hard nuclear cataract. Methods A total of 299 cases （ 312 eyes） in two groups with more than hard-Ⅲ nuclear cataract were observed, and treated with seamless line of small incision cataract extraction （ S-group, 161 eyes ） or conventional phacoemulsification （ P-group, 151 eyes）, but both with intraocular lens implantation. Surgery time, postoperative vision, corneal endothelium cell loss, corneal astigmatism and other complications related to the differences were compared between two groups. Results The average surgery time of S-group was（691 ± 89 ）s, （663± 97 ）s in P-group ,and there was statistical difference（P〉0.05）. At 1 day after the surgery,visual acuity with more than 0.5 was 142 eyes in S-group, 112 eyes in P-group; The loss rate of corneal endothelium cells was （ 10. 03 ±2.87）% in S-group, （ 18.31 ±3.34）% in P-group. At 1 month after the surgery,the visual acuity with more than 0.5 was 150 eyes in S-group, 140 eyes in P-group, and there was no significant difference （X^2 = 0. 024, P 〉 0.05 ） ; The loss rate of corneal endothelium cells was（8.51 ±2.62）% in S-group, （16. 11 ±3.76）% in P-group. There was significant difference with loss rate of corneal endothelium cells between two groups at either 1 day or 1 month post-operatively. About postoperative astigmatism with more than 1.0 DC,25.47% in S-group, 17.22% in P-group, and there was statistical difference （P 〈 0.05 ）. No significant difference was found with complications such as prolapsed of iris, posterior capsular rupture, and leakage of incision. Conclusion Seamless line of small incision cataract extraction and intraocular lens implantation is a good treatment option for patients with more than hard-Ⅲ nuclear cataract. It is worth to be popularized.

关 键 词：小切口 白内障囊外摘出 超声乳化 硬核白内障 

分 类 号：R779.66[医药卫生—眼科]