前房内劈核法和隧道内碎核法在小切口白内障囊外摘除术中的比较  

Comparison of chopping in anterior chamber and breaking nuclear in tunnel in the small incision extracapsular cataract extraction

作　　者：李恩辉[1] 赖筱琍[1] 

机构地区：[1]浙江省台州医院眼科中心,临海317000

出　　处：《中国眼耳鼻喉科杂志》2011年第4期234-236,共3页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的探讨前房内劈核和隧道内碎核两种手术方法在小切口白内障囊外摘除术的临床应用情况。方法 178例接受无缝线小切口白内障囊外摘除并人工晶状体植入患者按抽签形式随机分为两组:一组采用前房内劈核,另一组采用隧道内碎核,比较两种手术方法的并发症发生情况,并对两组病例术后视力及角膜散光定期随访观察。结果隧道内碎核组的术中并发症发生率明显低于前房内劈核组,分别为2/94和13/84(t=8.624,P=0.003),其中包括后囊破裂(t=4.970,P=0.026)和虹膜根部离断(t=4.369,P=0.037);两组间术后并发症的发生情况差异无统计学意义(t=1.611,P=0.204);两组患者术后视力及角膜散光的比较差异亦无统计学意义。结论隧道内碎核法和前房内劈核法均能获得较小的角膜散光和良好术后远期视力,但隧道内碎核具有较低的术中并发症发生率,临床上更值得推广应用。Objective To evaluate the clinical effect of chopping in anterior chamber and breaking nuclear in tunnel in the small incision extracapsular cataract extraction. Methods One hundred and seventy-eight eyes underwent small incision sutureless cataract extraction with intraocular lens implantation. Patients were randomly divided into two groups, one group was treated with chopping in anterior chamber, another group was treated with breaking nuclear in tunnel. Complications and postoperative visual acuity of the two groups were compared and the corneal astigmatism was followed up. Results The intraoperative complications of breaking nuclear in tunnel group （2/94） was significantly lower than the chopping in anterior chamber group （13/84） （ t = 8. 624, P = 0.003 ）, including posterior capsule rupture （ t = 4. 970, P = 0.026） and iris root detachment （t = 4.369,P = 0.037 ）. There was no significant difference in postoperative complications between the two groups（t = 1. 611 ,P =0.204）. No significant difference was found in visual acuity or corneal astigmatism between the two groups. Conclusions Both chopping in anterior chamber and breaking nuclear in tunnel in the small incision extracapsular cataract extraction can get less cornea astigmatism and good long-term vision. Furthermore, lower intraoperative complications occurred in breaking nuclear in tunnel, which might be more valuable in clinical application.

关 键 词：白内障囊外摘除术 人工晶状体 小切口 

分 类 号：R779.66[医药卫生—眼科]