玻璃体切除术后白内障手法碎核手术与超声乳化术效果比较  

Comparison of the efficacy between manual nucleus fragmentation and phacoemulsification surgery in cataract after vitrectomy

作　　者：何自芳 秦勤[1] 陈晖[1] 李一壮[1] 解正高 He Zifang;Qin Qin;Chen Hui;Li Yizhuang;Xie Zhenggao(Department of Ophthalmology,Affiliated Drum-Tower Hospital of Medical College of Nanjing University,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院眼科,南京210008

出　　处：《中华眼外伤职业眼病杂志》2021年第10期762-766,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的比较玻璃体切除术后白内障小切口手法碎核手术与超声乳化术的效果。方法回顾性病例对照研究。南京大学医学院附属鼓楼医院2015年6月至2020年6月玻璃体切除术后白内障手术59例(60眼)分为小切口手法碎核30例(30眼)为A组,超声乳化29例(30眼)为B组。比较两组术后视力、眼压、角膜内皮细胞密度及并发症,随访3个月。结果两组术后视力均较术前提高。术后1 d,A组视力优于B组(P<0.05);术后1周、3个月,两组眼压、视力比较差异均无统计学意义(P>0.05)。术后不同时间点角膜内皮细胞密度两组之间差异均无统计学意义(P>0.05)。术中并发症:A组出现晶状体后囊破裂者2眼。B组晶状体坠入玻璃体腔1眼,晶状体后囊破裂者3眼。术后1 d,A组、B组角膜水肿者分别为6眼及5眼,两组术后均未出现继发性青光眼、角膜内皮失代偿或眼内炎等严重并发症。结论手法碎核和超声乳化治疗玻璃体切除术后白内障两种手术方式效果相似。Objective To compare the efficacy between small incision manual nucleus fragmentation and phacoemulsification in the treatment of cataract after vitrectomy.Methods Retrospective case-control study.Total of 60 eyes of 59 patients with cataracts after vitrectomy from Jun.2015 to Jun.2020 in Affilicated Drum-Tower Hospital of Medical College of Nanjing University were divided into two groups.Thirty eyes of 30 patients in group A received small incision manual nucleofragmentation,and 30 eyes of 29 patients in group B received phacoemulsification.The visual acuity,intraocular pressure and corneal endothelial cell density between the two groups were compared before and after operation,and the occurrence of intraoperative and postoperative complications were observed.The patients were followed up for 3 months.Results The visual acuity of the two groups were improved at different times after operation.At 1 day after operation,the visual acuity of group A was better than that of group B,the difference was statistically significant(P<0.05).There was no significant difference in intraocular pressure or visual acuity between the two groups at 1 week and 3 months after operation(P>0.05).There was no significant difference in central corneal endothelial cell density between the two groups at different times after surgery(P>0.05).Intraoperative complications included rupture of the posterior capsule in 2 eyes of group A and 3 eyes of group B,and calcification of the posterior capsule occurred in 1 case of group A.In group B,1 patient's lens fell into the vitreous cavity.At 1 day after operation,there were 6 eyes of corneal edema in group A and 5 eyes in group B.There were no serious complication such as secondary glaucoma,corneal endothelium decompensation or endophthalmitis.Conclusion The efficacy of manual nucleus fragmentation and phacoemulsification is similar in cataracts after vitrectomy.

关 键 词：白内障 玻璃体切除 碎核 手法 超声乳化 

分 类 号：R779.66[医药卫生—眼科]