不同超声乳化术式治疗超高度近视并发白内障的疗效分析  

Different phacoemulsification for super high myopia complicated with cataract

作　　者：欧阳先明 李莉 张睿 覃郁 

机构地区：[1]贵州省黔东南侗族苗族自治州人民医院眼科,贵州省凯里市556000

出　　处：《眼科新进展》2015年第9期854-857,共4页Recent Advances in Ophthalmology

基　　金：贵州省黔东南苗族侗族自治州科技局科研课题基金资助(编号:2012J31101)~~

摘　　要：目的 比较囊膜上超声乳化和囊袋内原位超声乳化治疗超高度近视并发白内障的临床疗效。方法 选择2012年2月至2014年6月我院眼科住院的超高度近视合并白内障患者137例（167眼）,随机分成囊膜上组69例（86眼）采用囊膜上超声乳化治疗,囊袋内组68例（81眼）采用囊袋内原位超声乳化治疗。比较两组患者手术的超声能量参数、术后裸眼视力及最佳矫正视力、角膜内皮细胞密度以及并发症的发生情况。两组患者术后均随访3-6个月。结果 囊袋内组核硬度Ⅱ、Ⅲ、Ⅳ级实际超声乳化时间分别为（31.98±3.74）s、（81.23±5.58）s和（142.87±7.53）s;囊膜上组核硬度Ⅱ、Ⅲ、Ⅳ级分别为（14.84±2.74）s、（21.44±3.85）s和（74.89±5.97）s。囊袋内组核硬度Ⅱ、Ⅲ、Ⅳ级超声能量分别为（18.71±3.42）%、（25.49±3.91）%和（33.39±4.12）%;囊膜上组核硬度Ⅱ、Ⅲ、Ⅳ级对应为（9.04±2.05）%、（11.28±2.52）%和（18.96±3.79）%。囊袋内组核硬度Ⅱ、Ⅲ、Ⅳ级实际超声乳化时间和超声能量分别与囊膜上组核硬度同级比较,差异均有统计学意义（均为P〈0.01）。囊袋内组术后1 d裸眼视力及术后1个月最佳矫正视力分布情况与囊膜上组比较,差异均无统计学意义（均为P〉0.05）。且囊袋内组Ⅱ、Ⅲ、Ⅳ级患者角膜内皮细胞密度分别与囊膜上组核硬度同级患者比较,差异也均无统计学意义（均为P〉0.05）。囊膜上组术中并发症发生率为4.65%,囊膜内组为13.58%,两组比较差异有统计学意义（P〈0.01）。结论 囊膜上超声乳化治疗超高度近视并发白内障术后视力及对角膜内皮细胞的损伤程度与囊袋内超声乳化基本一致,但明显减少了术中并发症的发生,手术更安全。Objective To compare the clinical effects of capsule membrane phacoemulsification and capsular bag in situ phacoemulsification for super high myopia complicated with cataract.Methods A total of 137 patients（167 eyes） with super high myopia complicated with cataract hospitalized in our hospital from February 2012 to June 2014 were chosen and randomly divided into capsule membrane group with 69 patients（86 eyes）,who adopt capsule membrane phacoemulsification,as well as capsular bag group with 68 patients（81 eyes）,who adopt capsular bag in situ phacoemulsification.The ultrasonic energy parameters,postoperative uncorrected visual acuity（UCVA）,best corrected visual acuity（BCVA）,corneal endothelial cell density and occurrence of complications in two groups were compared.The two groups patients were followed up for 3-6 months.Results The actual phacoemulsification time in patients with nucleus hardness graded Ⅱ,Ⅲ and Ⅳ in capsular bag group were（31.98±3.74） s,（81.23±5.58）s and（142.87±7.53）s,respectively,which in capsule membrane group were（4.84±2.74）s,（21.44±3.85）s and（74.89±5.97） s,respectively;The average ultrasonic energy in patients with nucleus hardness graded Ⅱ,Ⅲ and Ⅳ in capsular bag group were（18.71±3.42）%,（25.49±3.91）%and（33.39±4.12）%,respectively,which in capsule membrane group were（9.04±2.05）%,（11.28±2.52）%and（18.96±3.79）%,respectively;The differences were statistical significant（all P〈0.01）.Compared with capsule membrane group,there was no statistical difference in UCVA at postoperative 1day and BCVA at postoperative 1 month of capsular bag group（all P〈0.05）.In addition,compared with capsule membrane group,there was no statistical difference in corneal endothelial cell density in patients with nucleus hardness graded Ⅱ,Ⅲ and Ⅳ of capsular bag group（all P〉0.05）.The incidence of intraoperative complication in capsule membrane group was4.65%,which in capsular bag group was 13.58%,the difference wa

关 键 词：超高度近视 白内障 超声乳化 

分 类 号：R776.105[医药卫生—眼科]