角膜缘为基底的结膜瓣在手法小切口白内障手术中应用的效果  

The efficacy of corneal limbus-based conjunctival flap in manual small incision cataract surgery

作　　者：刘斌[1] 覃小夏 黄文勇[1] 王兰花[1] Liu Bin Qin Xiaoxia Huang Wenyong Wang Lanhua(Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou 510060, China （ Liu B, Huang WY, Wang LH Department of Ophthalmology and Otorhinolaryngology, Traditional Chinese Medicine Hospital of Guiping City, Guiping, Guangxi 537200, China （ Qin XX)

机构地区：[1]中山大学中山眼科中心眼科学国家重点实验室,广州510060 [2]桂平市中医院院五官科,广西桂平537200

出　　处：《中华眼外伤职业眼病杂志》2017年第2期108-110,共3页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：广东省医学科研基金（B2014152）

摘　　要：目的评价以角膜缘为基底的结膜瓣在手法小切口白内障手术中应用的效果。方法在基层医院扶贫防盲活动中老年性白内障87例（87眼），按分层随机法随机分为以角膜缘为基底的结膜瓣手术组（A组）44例，和以穹隆为基底的结膜瓣手术组（B组）43例。比较两组的术中后囊破裂的发生率，手术耗时以及术后1、7和30d切口暴露的发生率。结果A组的术中后囊破裂发生率为4．55％（2／44），平均手术时间为（7．48±2．12）min，1、7和30d的切口暴露发生率依次为9．09％（4／44）、0％（0／44）、0％（0／44），B组的相应数据依次分别为4．65％（2／43），（8．03±1．98）min，25．58（11／43）、20．93％（9／43）、9．3％（4／43）。A组术后第1、7和30d的切口暴露发生率较B组低，差异均有统计学意义（x^2=4．145，10．272，4．290；P=0．042，0．001，0．038）。两组的后囊破裂发生率差异无统计学意义（x^2=0．001，P=0．981）。A组手术时间较B组短，差异有统计学意义（t=-2．430，P=0．038）。结论角膜缘为基底的结膜瓣应用于手法小切口白内障中使手术时间缩短，而且切口暴露的发生率较低，进一步提高了手术安全性。Objective To evaluate the clinical effect of limbus-based conjunctival flap in manual small incision cataract surgery. Methods Eighty-seven eyes of 87 patients with age related cataract were eligible for cataract surgery during one poverty alleviation and blindness prevention screening program at basic hospital. Stratified random sampling was used to randomly divide all patients into limbus-based group （group A） and fornix-based group （group B）. The differences between the two groups in surgical time, rate of posterior capsular rupture during the operation, and exposure rate of surgical incision at 1,7 and 30 days after surgery were analyzed. Results Forty-four eyes in group A, the rate of posterior capsular rupture during the operation was 4.55% （2/44） and mean surgical time was（7.48 ±2.12）rain; the exposure rate of surgical incision at 1, 7 and 30 days after surgery was 9.09% （ 4/44 ）, 0% （0/44）, 0% （ 0/44 ）, respectively. The corresponding figures for group B were 4.65% （ 2/43 ）, （ 8.03 ± 1.98 ） rain, 25.58% （11/43） ,20.93% （9/43） and 9.3% （4/43）. Compared to group B, exposure rate of surgical incision of group A at 1, 7 and 30 days after surgery was lower （x^2 =4. 145, 10. 272, 4. 290; P =0. 042,0.001, 0.038 ）and surgical time was shorter （t = -2. 430 ,P = 0. 038 ）. There was no significant difference in rate of posterior capsular rupture during the operation between the two groups （x^2 = 0. 001, P =0.981 ）. Conclusion Limbus-based conjunctival flap can shorter the surgical time and lower the exposure rate of surgical incision in manual small incision cataract surgery, which can further improve the safety of cataract surgery.

关 键 词：白内障手术 小切口 手法 结膜瓣 以角膜缘为基底 以穹隆部为基底 

分 类 号：R779.6[医药卫生—眼科]