硅油取出联合晶状体超声乳化术中3种取油方式效果比较  

Comparison of efficacy among three methods of silicone oil removal combined with phacoemulsification

作　　者：邵敬芝[1] 杜珊珊[1] 袁超峰[1] 张凤妍[1] Shao Jingzhi;Du Shanshan;Yuan Chaofeng;Zhang Fengyan(Department of Ophthalmology,the First Affiliated Hospital of Zhengzhou Universityy Henan Provincial Ophthalmic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院眼科河南省眼科医院,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2022年第4期246-252,共7页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：国家自然科学基金(81970785);河南省医学科技攻关计划联合共建项目(2018020065)。

摘　　要：目的比较硅油取出联合晶状体超声乳化术中3种硅油取出方式的效果。方法回顾性病例对照研究。收集郑州大学第一附属医院2019年1月至2020年12月玻璃体切除术后硅油填充眼伴有白内障84例(84只眼)的临床资料。患者均行硅油取出联合晶状体超声乳化人工晶状体植入术。根据不同的取油方式分为3组:A组, 27例经睫状体平坦部取出硅油;B组, 27例经瞳孔取出硅油;C组, 30例前房灌注下经瞳孔取出硅油。比较3组术前术后最佳矫正视力(BCVA)、眼压、角膜内皮细胞密度、手术耗时、眼部刺激症状持续时间及眼部并发症等。结果本研究3组患者术后视力均较术前提高(P<0.05), 而组间比较差异无统计学意义(H=1.73, P=0.421);术后1 d, A组与B组眼压差异无统计学意义(t=1.23, P=0.222), 但A组和B组眼压均低于C组(F=36.29, P<0.001);各组间及组内角膜内皮细胞密度比较差异均无统计学意义(均P>0.05);B组的手术耗时(28.63±2.22)min短于A组的(31.11±3.42)min(t=3.16, P=0.003), C组的手术耗时(23.80±3.50) min短于B组(t=6.28, P<0.001);眼部刺激症状持续时间比较, A组(7.37±1.15) d和B组(7.33±1.27 )d差异无统计学意义(t=0.11, P=0.911), C组的眼部刺激症状持续时间(1.60±1.59) d短于A组(t=15.56, P<0.001)和B组(t=14.93, P<0.001)。3组并发症发生情况差异无统计学意义(χ^(2)=0.37, P=0.829)。结论硅油取出联合晶状体超声乳化术中3种硅油取出方式均安全有效, 前房灌注经瞳孔硅油取出具有手术时间短及恢复快等优点。Objective To compare the clinical efficacy among three methods of silicone oil removal combined with phacoemulsification for cataract in silicone oil tamponade eye.Methods This was a retrospective case control study.The clinical data of 84 eyes of 84 cases with cataract and silicone oil filled eye from Jan.2019 to Dec.2020 in the First Affiliated Hospital of Zhengzhou University were collected.All patients underwent phacoemulsification and intraocular lens(IOL)implantation combined with silicone oil removal.The patients were divided into three groups based on different methods of silicone oil removal.In group A,27 cases received silicone oil removal through the pars plana of the ciliary body;in group B,27 cases received silicone oil removal through the pupil;in group C,30 cases received silicone oil removal through the pupil under anterior chamber perfusion.The preoperative and postoperative best corrected visual acuity(BCVA),intraocular pressure(IOP),corneal endothelial cell density,operative time,duration of irritation symptoms and ocular complications among the three groups were compared.Results Compared with preoperative visual acuity,postoperative visual acuity was improved in all three groups(P<0.05),but there was no significant difference among the three groups in this study(H=1.73,P=0.421).At 1 day after operation,there was no statistical difference in intraocular pressure between group A and group B(t=1.23,P=0.222),which were all lower than that in group C(F=36.29,P<0.001).There was no significant difference in corneal endothelial cell density among the three groups(all P>0.05).The operation time in group B was(28.63±2.22)min,which was shorter than the(31.1±13.42)min in group A(t=3.16,P=0.003),and the operation time in group C(23.80±3.50)min was shorter than that in group B(t=6.25,P<0.001).There was no difference in duration of irritation symptoms between group A(7.37±1.15)d and group B(7.33±1.27)d(t=0.112,P=0.911).The duration of irritation symptoms in group C(1.60±1.59)d was shorter than that in

关 键 词：硅油类 白内障 超声乳化白内障吸除术 玻璃体切除术 

分 类 号：R779.6[医药卫生—眼科]