玻璃体切除联合白内障超声乳化吸出与非联合手术屈光状态变化  

The refractive shifts of vitrectomy combined with cataract surgery and uncombined surgery

作　　者：宋秋平[1] 陈彬川[1] 

机构地区：[1]郑州大学第二附属医院眼科,河南450014

出　　处：《中国实用眼科杂志》2014年第5期564-566,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的研究玻璃体联合白内障超声乳化吸出术、非联合术式屈光状态变化。方法临床病例对照研究。对2010年3月至2013年3月在郑州大学第二附属医院眼科治疗玻璃体视网膜病变合并白内障患者74例（79只眼），根据术式不同，分为非联合组33例（36只眼）和联合组，并据人工晶状体植入时间，联合组又分为联合1期组17例（18只眼）；联合2期组24例（25只眼）。分析比较各组术前预测屈光度（预测值）与术后实际屈光度（实际值）。结果比较联合1期组预测值与实际值，差异具有统计学意义（t=-3．809，P〈0．05）；联合2期组、非联合组术前屈光预测值与术后屈光实际值比较，差异无统计学意义（t=1．654，P〉0．05；t=1．537，P〉0．05）；手术后联合1期组与非联合组、联合2期组屈光变化值比较，差异均具有统计学意义（t=-4．536，P〈0．05；t=-4．22，P〈0．05）；手术后联合2期组与非联合组屈光变化值比较，差异无统计学意义（t=0．225，P〉0．05）。结论玻璃体切除联合白内障超声乳化吸出、人工晶状体1期植入手术后患者屈光状态变化趋于向近视偏移，非联合手术与联合2期手术则未引起该改变。Objective To investigate the refractive shifts of vitrectomy combined with cataract surgery and uncombined surgery. Methods The clinical data of vitreoretinal diseases and cataract were retrospective analyzed including 74 cases （79 eyes） were divided into two groups by the kind of surgery： combined group and uncombined group. Combined group was further divided into two sub-groups by the time of intraocular lens （IOL） implantation： one-stage group and two-stage group. The differences between predictive diopter （PD） and actual diopter （AD） were compared among three groups. Results In the one-stage group, the difference between PD and AD was significant （t =-3.809, P 〈0.05）, the difference between PD and AD was not significant （t =1.654, P 〉0.05; t = 1.537, P 〉0.05） in two-stage group and uncombined group. Patients underwent combined one-stage surgery showed a statistically significant myopic shift compared with those underwent combined two-stage surgery and uncombined surgery （-4.536, P 〈0.05; t =-4.22, P 〈0.05）, the refractive shift of two-stage group and uncombined group was not significant difference （t =0.225, P 〉0.05）. Con-clusions Combined surgery of phacoemulsification, one-stage IOL implantation and vitrectomy tends to shift the actual refractive status to mYoPia, uncombined surgery and two-stage surgery has no this change.

关 键 词：玻璃体切除术 白内障 联合手术 屈光 

分 类 号：R779.66[医药卫生—眼科]