1.4mm双手微切口白内障超声乳化联合人工晶状体植入术的临床应用  

Clinical application of 1.4mm bimanual microphacoemulsification with IOL implantation

作　　者：周斌兵[1] 林敏[1] 朱宇东[1] 林文雄[1] 鲍炯琳[1] 李青[1] 周四萍[1] 臧晶[1] 

机构地区：[1]广东药学院附属第一医院眼科,广东广州510080

出　　处：《眼视光学杂志》2009年第6期431-434,共4页Chinese Journal of Optometry & Ophthalmology

基　　金：广东省医学科研基金资助项目(A2006326)

摘　　要：目的观察1.4mm双手微切口白内障超声乳化联合人工晶状体植入术的临床效果,并与传统同轴超声乳化手术进行比较。方法年龄相关性白内障患者48例(56眼),年龄55～75岁,晶状体混浊分级为Ⅱ～Ⅲ级,随机分为2组,每组28眼。Ⅰ组行1.4mm双手微切口冷超声乳化联合Acri.Smart人工晶状体植入术,Ⅱ组行传统同轴超声乳化人工晶状体植入术。术中记录超声乳化时间和能量。术后第1天、第1周和第1个月观察随访,记录术后的散光改变、裸眼视力和手术并发症,术后1个月同时检查最佳矫正视力。采用卡方检验和t检验对所得数据进行分析。结果术中,Ⅰ组平均超声乳化时间为(0.75±0.63)min,超声乳化能量为9.6%(Ⅲ级核)和11.6%(Ⅳ级核);Ⅱ组平均超声乳化时间为(1.15±0.56)min,超声乳化能量为12.5%(Ⅲ级核)和20.4%(Ⅳ级核);两组比较,Ⅰ组超声时间更短,超声能量更少,差异均有统计学意义(P<0.05)。视力变化:术后第1天、第1周和第1个月,Ⅰ组裸眼视力≥0.5的分别占82.14%、92.86%和100%,Ⅱ组裸眼视力≥0.5的分别占53.57%、71.43%和96.43%;术后第1天、第1周,Ⅰ组视力≥0.5者均多于Ⅱ组,两组差异有统计学意义(P<0.05),术后第1个月两组最佳矫正视力≥0.8者均占92.86%,无差异。角膜散光变化:术前与术后比较,两组角膜散光均有不同程度改变;术后第1天,Ⅱ组角膜散光大于Ⅰ组(P<0.05),术后第1周和第1个月,两组角膜散光差异无统计学意义(P>0.05)。结论双手冷超乳联合Acri.Smart人工晶状体植入可以使白内障手术切口缩小至1.4mm,手术源性散光更小,前房密闭稳定,手术安全可靠。Objective To investigate the clinical outcomes of bimanual microphacoemulsification with implantation and compare it to traditional phacoemulsification in cataract surgery.Methods Fortyeight eyes of 56 patients with age-related cataract were randomly divided into two groups.The age range was 55～75 years.There were 28 eyes in each group.Group Ⅰ underwent 1.4 mm bimanual cold phacoemulsification while group Ⅱ underwent traditional phaco.Phaco power and time were recorded for each procedure.Follow-up exams were performed on I day, 1 week avd 1 month after surgery. Preoperative and postoperative astigmatism changes, postop-erative visual acuity and complications were assessed for the two grnups. Statistical analysis was done with a X^2 test and t-test. Results The average phaco lime （EPT） for group 1 was （0.75±0.63） min, and average power tAP） was 9.6% for a relatively soft nucleus （grade Ⅲ） and 11.6% for a grade Ⅳ nucleus; the EPT for group Ⅱ was （1.15±0.56）rain, AP was 12.5% for a grade m nucleus and 20.4% for a grade Ⅳ nucleus. A statistically significant difference was found in EPT and AP between the two groups （P〈0.05）. On the first day, first week and first month after surgery, a visual acuity of 0.5 or better was attained for 82.14%, 92.86% and 100% of patients in group Ⅰ , respectively, and fbr 53.57%, 71.43% and 96.43% of patients in group Ⅱ, respectively. A visual acuity of 0.8 or better was attained in 92.86% in each group. A statistically significant difference was found between preoperative measurements and 1 day anti 1 week postoperatively, hut no statistically significant difference was found at 1 month postoperatively. There were statistically significant differences between preoperative and postoperative astigmatism changes in both groups. There was a statistieally significant difference in astigmatism between the two groups 1 day postoperatively （P〈0.05）, but there was no statistically significant difference after one week and one month （P〉0.05�

关 键 词：双手法 微切口白内障超声乳化 人工晶状体植入 视力 角膜散光 

分 类 号：R779.66[医药卫生—眼科]