两种小切口白内障摘除术在高龄硬核白内障中应用比较  

The clinical effect of two manual small incision cataract surgery on the cataract with a hard core of aged patients

作　　者：刘海凤[1] 杨洋[1] 李艳华[1] 余涵[1] 

机构地区：[1]新乡医学院第三附属医院眼科,河南453003

出　　处：《中国实用眼科杂志》2014年第5期570-573,共4页Chinese Journal of Practical Ophthalmology

基　　金：河南省医学科技攻关计划（200903098）;河南省重点学科开放课题（ZD200990）

摘　　要：目的对比观察两种不同手法无缝线小切口白内障摘除术治疗高龄硬核白内障的临床效果。方法临床病例对照研究。对2010年3月至2012年3月在新乡医学院第三附属医院眼科手术治疗高龄硬核白内障患者72例（76只眼），采用手法无缝线小切口白内障摘除术，根据术中处理晶状体核的方式，分为两组：一组为采用囊袋内手法劈核组36例（38只眼）；另一组为采用phaeo娩核技巧，将核完整娩出的改良组36例（38只眼）。对比观察两组手术时间、术后视力、眼压、角膜内皮细胞丢失率及术中并发症。结果囊袋内手法劈核组患者的平均手术时间、角膜内皮细胞丢失率、术中并发症发生率分别为（8±2．02）min、（9．23±3．79）％、5．26％（2／38），改良组分别为（7±2．11）min、（7．11±3．67）％、5．26％（2／38）。两组间手术时间比较，差异有统计学意义P〈0．05（t=4．38，P=0．030）；角膜内皮细胞丢失率比较，差异有统计学意义P〈0．05（t=4．44，P=0．021）；术中并发症两组各自发生2例（2只眼），并分别于囊袋内及睫状沟植入人工晶状体。结论手法无缝线小切口白内障摘除术中采用phaeo的娩核技巧，将核一次性完整娩出，能节省手术时间，保护角膜内皮细胞功能，是治疗高龄硬核白内障患者安全、有效地手术方法。Objective To compare the clinical effect of two manual small incision cataract sur-gery on the cataract with a hard core of aged patients. Methods A clinical case-control study. Sev-enty-two cases （76 eyes） with hard core cataract in the Third Affiliated Hospital of Xinxiang Medi-cal University were selected. All the patients accepted the manual small incision cataract surgery. Ac-cording to the different method of the treatment of lens, all the patients were divided into two groups. In one group, the manual nucleus fragmentation was selected in capsular bag. In the other group, the nucleus delivery of phaco was selected to deliver the nuclear completely （improved group）. Then, the mean operation time, postoperative vision, intraocular pressure, the endothelium cell loss ratio and the intraoperative complication were observed and compared. Results The mean operation time, the endothelium cell loss ratio and the intraoperative complication of the group with the manual nucleus fragmentation in capsular bag were （8±2.02） min, （9.23±3.79）% and 5.26% （2/ 38）, respectively. The values of above indexes of the improved group were （7±2.11） min, （7.11± 3.67）% and 5.26% （2/38）, respectively. There were significant difference in the operation time be-tween two groups （t =4.38, P =0.030）, and the endothelium cell loss ratio between two groups had statistical significance （t =4.44, P =0.021）. There were two intraoperative complications in every group. Conclusions The results suggest that the selection of the nucleus delivery of phaco in the manual small incision cataract surgery can completely extract the nuclear, save more operation time and protect the function of corneal epithelium and endothelial cells. So, this method is the more safe and effective one for the therapy of aged patients with very hard core cataract.

关 键 词：手法无缝线小切口白内障摘除术 硬核 囊袋内手法劈核 娩核 

分 类 号：R779.6[医药卫生—眼科]