3mm小切口手法劈核术治疗硬核白内障的疗效观察  

Effective observation on 3 mm small incision of manual chopping nucleus technique in treating hard nuclear cataract

作　　者：曹凤芝[1] 冯斌炜[1] 

机构地区：[1]重庆市梁平县人民医院眼科,405200

出　　处：《检验医学与临床》2015年第16期2404-2405,共2页Laboratory Medicine and Clinic

摘　　要：目的观察3mm小切口手法劈核术治疗Ⅳ~Ⅴ级硬核白内障的临床疗效。方法选取2013年1月至2014年12月该院眼科收治的白内障患者221例共242眼,按照手术方式的不同分为试验组及对照组。试验组纳入患者143例157眼（其中Ⅳ级核119眼,Ⅴ级核38眼）,行3mm带球结膜的角巩膜缘隧道式切口后,进行手法核周逐块劈开粉碎后将硬核旋转刨出,最后进行可折叠人工晶体植入;对照组纳入患者78例85眼（其中Ⅳ级核61眼,Ⅴ级核24眼）,行4mm中央手法劈核摘除术后植入折叠人工晶体。比较2组术后并发症及术后视力变化情况。结果试验组术中后囊破裂2眼（1.27%）,角膜水肿29眼（18.5%）;对照组术中晶体后囊膜出现破裂3眼（3.5%）,角膜水肿34眼（40.0%）,2组术后并发症比较差异有统计学意义（P〈0.05）。试验组术后第一周视力优于或等于0.5的有106眼（67.5%）,1个月复查视力光感优于或等于0.5的有139眼（88.5%）;对照组术后第1周视力优于或等于0.5的有46眼（54.1%）,1个月后复查视力优于或等于0.5的有69眼（81.2%）,2组术后视力变化情况比较,差异有统计学意义（P〈0.05）。结论对Ⅳ~Ⅴ级硬核行核周手法劈核术可明显减少术中、术后并发症,且能提高手术效果。Objective To observe the clinical effect of 3 mm small incision of manual chopping nucleus tech- nique in treating grade Ⅳ and Ⅴ hard nucleus cataract. Methods 221 cataract patients （242 eyes） from January 2013 to December 2014 in the ophthalmology department of Chongqing Liangping People＇s Hospital were selected and di- vided into the experimental group and the control group. The experimental group（143 cases, 157 eyes including 119 eyes of grade Ⅳ hardness nucleus and 38 eyes of grade Ⅴ hardness nucleus） was performed 3 mm ball conjunctiva corneoscleral limbus tunnel type incision, the followed soft part o1 hard nucleus was chopped firstly, then the center of hard nucleus was rotated or divided into pieces for removing,lastly the foldable intraocular lens were implanted. The control group（78 cases,85 eyes including 61 eyes of grade Ⅳhardness nucleus,and 24 eyes of grade V hardness nu- cleus） was performed the central 4 mm of manual chopping nucleus pulposus,then the foldable intraocular lens was implanted. Postoperative complications and postoperative visual acuity were compared between the two groups. Re- suits Posterior capsule rupture in 2 eyes （1.27%） and corneal edema in 29 eyes （18.5%） occurred in the experi- mental group, which in the control group were 3 eyes （3.5 % ） and 34 eyes （40 % ） respectively, there were statistical ly significant difference in two indexes above between the both groups（P〈0.05）. In the experimental group, the vis- ual acuity at postoperative 1 week was better than 0.5 in 106 eyes （67.5 % ） in the experimental group, and which af- ter 1-month re-examination was better than 0.5 or equal to 0.5 in 139 eyes （88.5%）,but which at postoperative 1 week was in 46 eyes（54.1 %） and which after 1-month re-examination was in 69 eyes（81.2 %） in the control group, the There differences between two groups were statistically significant （P〈0.05）. Conclusion The manual chopping nucleus for grade Ⅳ-Ⅴ hard nucleus can significant

关 键 词：小切口 白内障摘除术 手法劈核 

分 类 号：R776.1[医药卫生—眼科]