改良无缝线技术应用于硅油眼联合手术中的效果分析  

Effect analysis of the modified sutureless technique applying in the silicone oil eye combined surgery

作　　者：李植源[1] 王海彦[2] 欧玉仑[1] 周小平[1] 邝国平[1] 

机构地区：[1]郴州市第一人民医院眼科 [2]郴州市第一人民医院手术室,湖南郴州423000

出　　处：《湘南学院学报（医学版）》2017年第2期24-28,共5页Journal of Xiangnan University（Medical Sciences）

基　　金：郴州市第一人民医院优秀青年创新基金项目(N2015-005)

摘　　要：目的探讨两种微切口无缝线技术在硅油填充眼并发性白内障联合手术治疗过程中较传统巩膜缝线技术的安全性及学习曲线差异性,进而明确该类疾病之优选治疗方案。方法采用回顾性病例分析法,将就诊于我院,并已经分别采用微切口白内障超声乳化联合20G巩膜穿刺缝线法(18眼,18例)、微切口白内障超生乳化联合23G巩膜穿刺无缝线法(13眼,13例)、微切口白内障超声乳化晶体后囊膜切开法(12眼,12例)的患者术前、术后的最佳矫正视力、手术所需时间、术后第1天眼压、并发症发生情况进行记录并分析。结果将术前、术后第3月最佳矫正视力改变的程度进行组间比较,所有患者在视力改变方面差异无统计学意义(P>0.05)。联合手术中采取23G巩膜穿刺无缝线组较20G巩膜穿刺缝线组手术时间缩短(t=2.31,P<0.05),采用晶体后囊膜切开并未能缩短手术时间;与20G巩膜缝线硅油取出联合手术方式比较,联合23G手术方式并未减少并发症发生。但联合巩膜23G穿刺较晶体后囊膜切开在降低术中低眼压及脉络膜脱离发生等方面更具优势(P<0.05)。结论 1.8 mm透明角膜切口联合无缝合硅油取出术,手术时间短、术中并发症低;采用晶体后囊膜切开硅油取出,术前应长期观察,检测视网膜情况,术中后囊膜切开操作学习曲线长,应谨慎选择该术式。Objective Compared with traditional scleral suture technique, to study the safety and learn- ing curve difference among two types of microincisional sutureless technique in silicon oil tamponade eyes in- tereurrent cataract combine surgery, then to implement the preferred treatment plan of these diseases. Meth- ods By use of case-review method, the basic data of patients with eyes of silicone oil tamponade combined cataract were collected. The optional surgery types are mieroincis ning with 20G scleral puncture suture method（18 eyes, 18 patients onal cataract phacoemulsification combi- , microincisional cataract phacoemulsifi- cation combining with 23G scleral puncture sutureless method（ 13 eyes, 13 patients） and microincisional cat- aract phacoemulsification with posterior capsule incision. The clinic data including the best corrected visual acuity（BCVA） variation before and after surgery,the total surgery time, the intra ocular pressure （IOP） at the first day after surgery, the complications during operation were recorded and analyzed. Results When comparing the degrees of BCVA in pre- and post-operation among those groups after three months, it turns out that the differences in visual acuity changes were of no statistical significance （ P〈0.05 ）. The total sur- gery time of the group using 23G sclera puncture sutureless method was shorter than the group which used 20G sclera puncture suture method in combined surgery（ t=2.31 ,P〈0.05） , but using posterior capsule in- cision could not reduce the total surgery time;compared with the 20G scleral puncture suture method, the combined 23G sclera puncture sutureless method could not reduce the complication, but it had advantages on reducing the lower intraocular pressure and the incidence rate of choroidal detachment during operation than posterior capsule incision（ P〈0.05）. Conclusion The 1.8 mm transparent corneal incision combining with sutureless silicone removal surgery had shorter operation time and fewer complications; more tim

关 键 词：微切口 硅油 并发性白内障 无缝线 

分 类 号：R776[医药卫生—眼科]