超声乳化手术与小切口囊外摘除术治疗高龄白内障的疗效和安全性对照研究  

Efficacy and safety of phacoemulsification and extracapsular extraction with small incision in the treatment of elderly cataract patients

作　　者：杨阳 朱飞 李达 YANG Yang;ZHU Fei;LI Da(Department of Ophthalmology,Xingyuan Hospital of Yulin,Yulin 719000,Shaanxi,CHINA;Department of Ophthalmology,Yulin Hospital of Traditional Chinese Medicine,Yulin 719000,Shaanxi,CHINA;Department of Ophthalmology,Aier Eye Hospital of Yulin,Yulin 719000,Shaanxi,CHINA)

机构地区：[1]榆林市星元医院眼科,陕西榆林719000 [2]榆林市中医医院眼科,陕西榆林719000 [3]榆林市爱尔眼科医院眼科,陕西榆林719000

出　　处：《海南医学》2022年第12期1566-1569,共4页Hainan Medical Journal

基　　金：陕西省卫生厅科研基金(编号:2018D122)。

摘　　要：目的比较超声乳化手术与小切口囊外摘除术治疗高龄白内障的疗效和安全性。方法回顾性分析2019年2月至2021年1月榆林市星元医院收治的166例(200眼)高龄白内障患者的临床资料,根据手术方法不同分为对照组(n=80,90眼)和观察组(n=86,110眼),对照组患者采用超声乳化术治疗,观察组患者采用小切口囊外摘除术治疗。比较两组患者手术前后的视力、角膜散光度、眼压、黄斑区厚度、细胞密度、六角形细胞比率,以及并发症发生情况。结果术前,两组患者的视力、角膜散光度、眼压及黄斑区厚度比较差异均无统计学意义(P>0.05);术后1 d、3 d、7 d,两组患者的视力上升,术后7 d、1个月,两组患者的角膜散光度上升,黄斑区厚度均增厚,术后12 h、24 h、48 h,两组患者的眼压上升,差异均具有统计学意义(P<0.05),且观察组患者术后1 d、3 d的视力分别为(0.56±0.14)、(0.82±0.23),明显高于对照组的(0.46±0.10)、(0.74±0.17),术后7 d、1个月的黄斑区厚度分别为(231.52±20.08)μm、(245.53±23.69)μm,明显小于对照组的(238.64±22.11)μm、(257.12±26.08)μm,差异均有统计学意义(P<0.05),但两组患者术后7 d的视力和术后3个月的黄斑区厚度比较差异均无统计学意义(P>0.05);观察组患者术后12 h、24 h的眼压分别为(22.56±4.14)mmHg、(17.16±3.02)mmHg,明显低于对照组的(27.93±6.96)mmHg、(23.15±5.34)mmHg,差异均有统计学意义(P<0.05),但两组患者术后48 h的眼压比较差异无统计学意义(P>0.05);术前两组患者的细胞密度、六角形细胞比率比较差异均无统计学意义(P>0.05),术后两组患者的细胞密度、六角形细胞比率均较术前明显降低,差异均有统计学意义(P<0.05),且观察组患者术后的细胞密度和六角形细胞比率分别为(2449.25±90.33)个/mm^(2)、(53.46±6.55)%,明显高于对照组的(2250.83±84.26)个/mm^(2)、(49.26±4.78)%,差异均具有统计学意义(P<0.05);术后观察组患者Objective To compare the efficacy and safety of phacoemulsification and extracapsular extraction with small incision in the treatment of elderly cataract patients.Methods The clinical data of 166 elderly cataract pa-tients(200 eyes)admitted to Xingyuan Hospital of Yulin between February 2019 and January 2021 was retrospectively analyzed.The patients were divided into a control group(n=80,90 eyes)and an observation group(n=86,110 eyes)ac-cording to different surgical methods.Patients in control group were treated with phacoemulsification,and patients in ob-servation group were treated with extracapsular extraction with small incision.The terms of visual acuity,corneal astig-matism,intraocular pressure,macular thickness,cell density and hexagon cell ratio before and after operation,and the in-cidence of complications were compared between the two groups.Results There was no significant difference in visual acuity,corneal astigmatism,intraocular pressure or macular thickness between the two groups before operation(P>0.05).Visual acuity of the two groups increased at day 1,day 3 and day 7 after operation.Corneal astigmatism and macular thicknesses of the two groups increased at day 7 and at 1 month after operation.Intraocular pressure of the two groups in-creased at 12 h,24 h and 48 h after operation,with statistically significant difference(P<0.05).The visual acuity at day 1 and day 3 after operation in the observation group was 0.56±0.14 and 0.82±0.23,which was significantly higher than 0.46±0.10,0.74±0.17 in the control group,and the macular thicknesses at day 7 after operation and at 1 month after oper-ation were(231.52±20.08)μm and(245.53±23.69)μm,significantly smaller than(238.64±22.11)μm and(257.12±26.08)μm of the control group(P<0.05).There was no significant difference in macular thickness between the two groups at day 7 after operation and at 3 months after operation(P>0.05).The intraocular pressure at 12 h and 24 h after operation in the observation group was(22.56±4.14)mmHg and(17.16±3.02)mm

关 键 词：高龄 白内障 超声乳化术 小切口囊外摘除术 疗效 安全性 

分 类 号：R779.66[医药卫生—眼科]