小切口与超声乳化白内障摘除术治疗糖尿病硬核性白内障的临床对比性研究  

Clinical comparison of small incision and phacoemulsification cataract extraction in the treatment of diabetic hardcore cataract

作　　者：张大卫[1] 孔凡宏[1] 

机构地区：[1]首都医科大学附属北京潞河医院眼科,北京101149

出　　处：《临床和实验医学杂志》2017年第14期1440-1444,共5页Journal of Clinical and Experimental Medicine

摘　　要：目的比较小切口白内障摘除术与超声乳化白内障摘除术治疗糖尿病硬核性白内障的术后效果。方法回顾性分析2014年9月至2015年9月首都医科大学附属北京潞河医院眼科住院的2型糖尿病硬核性白内障患者59例(69只眼),分为小切口白内障摘除术组(小切口组)30例36只眼和超声乳化白内障摘除术组(phaco组)29例33只眼。记录术前以及术后3个月不同时间点最佳矫正视力(BCVA)、黄斑区中心凹厚度(CMT)的变化,并观察术后并发症发生情况。结果术后随访3个月。无论小切口组还是phaco组,术后1天、1周、1月、3月BCVA均优于术前,差异有统计学意义(P<0.05);两组间比较,小切口组术后1天、1周的BCVA较phaco组好,但差异无统计学意义(P>0.05),1月及3月两组BCVA比较差异无统计学意义(P>0.05)。无论小切口组还是phaco组,术后1月和3月CMT和术后1周(相当于治疗前)比较,均不同程度增厚,差异有统计学意义(P<0.05);两组间比较,小切口组术后1月CMT较phaco组增厚,但两组术后1月及3月CMT比较,差异无统计学意义(P>0.05)。术后1天phaco组患者角膜水肿的发生比率高于小切口组,但差异无统计学意义(P>0.05);术后1周两组患者角膜水肿均明显消退。结论治疗糖尿病硬核性白内障,两种手术方式都可取得良好术后效果;影响早期视力的原因主要为术后角膜水肿。Objective To compare the postoperative efficacy of small-incision surgery with that of phacoemulsification on hard nuclear cataract in diabetic patients.Methods Fifty-nine diabetic patients （69 eyes） with hard nuclear cataract were divided into small-incision cataract extraction group（small-incision surgery group） including thirty patients （36 eyes） and phacoemulsification group （phaco surgery group） including twenty-nine patients （33 eyes）.The best-corrected visual acuity （BCVA） and central macular thickness （CMT） were measured before and after cataract surgery in three months.At the same time, postoperative complications were observed and recorded.Results BCVA at the 1-day, the 1-week, the 1-month and the 3-month postoperative were better than that preoperative, and the difference had significance （P〈0.05）.Comparision between the two groups , the BCVA at the 1-day and the 1-week postoperative in small-incision surgery group was better than that in phaco surgery group, but the difference had no significance （P〉0.05）.When comparing the BCVA at the 1-month and the 3-month, the difference had no significance （P〉0.05）.CMT at the 1-month and the 3-month postoperative increased differently when compared with CMT at the 1-week（same as preoperative）, the changes had significance （P〈0.05）.Comparision between the two groups, CMT at the 1-month in small-incision surgery group was thicker than that in phaco surgery group, but the difference was not significant （P〉0.05）, Similarly when comparing CMT at the 3-month.Occurrence ratio of corneal edema in phaco surgery group was higher than that in small-incision surgery group, but the difference was not significant （P〉0.05）.Corneal edema of two groups patients almostly disappeared at the 1-week postoperative.Conclusion Two kinds of surgical methods can achieve good postoperative effect on hard nuclear cataract in diabetic patients.The main reason for the early low visual outcome was corneal edema after surgery.

关 键 词：糖尿病 硬核性白内障手术 小切口 超声乳化 

分 类 号：R587.2[医药卫生—内分泌] R779.66[医药卫生—内科学]