水冲法抛光后囊膜在白内障手术中的应用研究  

The Application of Washing-out Technique in Polishing the Posterior Capsule of Cataract Surger

作　　者：李庚营 车慧欣 杜丽玲 何伟 LI Gengying;CHE Huixin;DU Liling(Department of Ophthalmology,Huludao Heshi Ophthalmic Hospital Co.,Ltd.,Liaoning 125000,China)

机构地区：[1]辽宁省葫芦岛何氏眼科医院有限公司,葫芦岛125000 [2]沈阳何氏眼科医院有限公司,沈阳110000

出　　处：《航空航天医学杂志》2019年第11期1303-1306,共4页Journal of Aerospace medicine

基　　金：辽宁省自然科学基金资助(编号:2014022022);辽宁省卫计委临床能力建设项目(编号:LNCCCD31-2015)

摘　　要：目的探讨白内障超声乳化术中运用水冲法抛光技术对后囊膜抛光的安全性及有效性。方法患者随机分为冲洗组(常规A/I头联合水针冲洗抛光后囊膜法,n=100)和对照组(常规单纯A/I头抛光后囊膜法,n=100)。观察术后最佳矫正视力、眼压及残留皮质、IOL位置,有无后发障,并使用Pentacam眼前节分析仪测量后囊膜厚度变化,并进行统计学分析。结果冲洗组术中未发生后囊膜破裂等并发症。术后第一天视力,冲洗组(0.6±0.28)与对照组(0.4±0.24)比较,差异有统计学意义(P<0.05);术后残余皮质的发生率,冲洗组(5%)与对照组(14%)比较差异有统计学意义(χ^2=4.711,P<0.05)。术后6月、1年、3年冲洗组后发障发生率低于对照组,两组后发障发生率比较差异均有统计学意义(χ^2=8.303、11.656、11.481,P=0.004、0.001、0.001,均为P<0.05)。术后1月、6月、1年、3年,Pentacam前节分析仪测量后囊膜厚度两组比较差异有统计学意义(均为P=0.000)。术后6月、1年、3年最佳矫正视力>0.5的有效率两组比较差异有统计学意义(χ~2=6.948、5.882、4.978,P=0.008、0.015、0.026)。术后1年、3年最佳矫正视力>0.7的有效率冲洗组(55%、48%)与对照组(39%、36%)比较(χ^2=5.138、2.956,P=0.023、0.086,均P<0.05)。结论白内障超声乳化白内障手术中联合水冲法进行后囊膜抛光技术安全有效,可减少术中并发症及后发障的发生,能更好提高患者的视力。Objective To investigate the safety and efficacy of water-flushing polishing technique in cataract phacoemulsification.Methods The patients were randomly divided into two groups:irrigation group(routine A/I head combined with water needle rinsing and polishing posterior capsule n=100)and control group(routine simple A/I head polishing posterior capsule method n=100).The visual acuity,intraocular pressure and the location of residual cortex were observed on the first day after operation.The best corrected visual acuity was observed within 1 month,6 months,1 year and 3 years after operation.The thickness of posterior capsule was measured by Pentacam anterior segment analyzer and analyzed statistically.Results There were no complications such as rupture of posterior capsule in irrigation group.The visual acuity of the irrigated group(0.6±0.28)was significantly higher than that of the control group(0.4±0.24)on the first day after operation(P<0.05),and there was a significant difference in the incidence of residual cortex between the irrigated group(5%)and the control group(14%)(χ~2=4.711,P<0.05).There was significant difference in the incidence of PCO between the two groups at 6 months,1 year and 3 years after operation(χ^2=8.303,11.656,11.481,P=0.004,0.001,0.001,P<0.05).The thickness of posterior capsule measured by Pentacam anterior segment analyzer in 1 month,6 months,1 year and 3 years after operation was significantly different between the two groups(P<0.000).Six months,one year,and three years after operation,the effective rate of the irrigation group with the best corrected visual acuity>0.5(79%,76%,73%)and the control group(62%、60%、58%)had significant differences(χ^2=6.948、5.882、4.978,P=0.008,0.015,0.026).The effective rate of the irrigation group with the best corrected visual acuity>0.7 was higher than that of the control group,and the comparison between the two groups(χ^2=5.138,2.956,P=0.023、0.086,P<0.05).Conclusions The technique of posterior capsule polishing in cataract phacoemulsificati

关 键 词：后囊膜抛光 后发障 白内障手术 

分 类 号：R776.1[医药卫生—眼科]