硬核白内障超声乳化术与小切口碎核摘除术的应用效果比较  

Comparison on the Application Effects of Phacoemulsification and Small Incision Chopping Nucleusextraction on Hard-Nucleus Cataract

作　　者：胡成功 夏花如 种平[3] HU Chenggong;XIA huaru;ZHONG Ping(Department of Ophthalmology,Huimin Hospital of Puyang,Puyang 457099,China;Jiyuan Jianfeng Eye Hospital,Jiyuan 459000,China;Ophthalmology Department,Henan Provincial People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]濮阳惠民医院眼科,河南濮阳457099 [2]济源尖峰眼科医院,河南济源459000 [3]河南省人民医院眼科,河南郑州450000

出　　处：《河南医学研究》2025年第3期482-485,共4页Henan Medical Research

摘　　要：目的 对比分析硬核白内障超声乳化术与小切口碎核摘除术的应用效果,以期为临床术式选择提供依据。方法 回顾性抽取2019年3月至2021年12月濮阳惠民医院收治的120例(120眼)硬核白内障患者的诊治资料,根据手术方式分为超声乳化组(64例,硬核白内障超声乳化术)、小切口组(56例,小切口碎核摘除术)。对比两组视力、眼压、角膜内皮细胞(CECs)指标[内皮细胞密度(ECD)、中央角膜厚度(CCT)、六角形细胞比例]、并发症。结果 与术前比较,术后8周超声乳化组和小切口组裸眼视力、眼压差异有统计学意义(P<0.05);术后8周,超声乳化组和小切口组术后裸眼视力、散光程度及眼压差异无统计学意义(P>0.05)。与术前比较,小切口组ECD、六角形细胞比例均降低,超声乳化组六角形细胞比例降低,差异有统计学意义(P<0.05),术后8周小切口组ECD、六角形细胞比例低于超声乳化组,CCT高于超声乳化组,差异有统计学意义(P<0.05)。小切口组并发症发生率低于超声乳化组(P<0.05)。结论 超声乳化术与小切口碎核摘除术能改善硬核白内障患者视力恢复和视觉质量,对散光、眼压的影响程度类似,但后者后囊膜破裂等并发症风险更低,对CECs数量、形态及CCT的影响更小。Objective To compare and analyze the application effects of phacoemulsification and small incision chopping nucleus extraction on hard-nucleus cataract,to provide evidences for selection of clinical surgical methods.Methods The diagnosis and treatment data of 120 patients(120 eyes)with hard nuclear cataract admitted to Huimin Hospital of Puyang from March 2019 to December 2021 were retrospectively extracted.According to the surgical methods,they were divided into phacoemulsification group(64 cases,hard nuclear cataract phacoemulsification)and small incision group(56 cases,small incision nucleus fragmentation extraction).The visual acuity,intraocular pressure,corneal endothelial cells(CECs)indexes[endothelial cell density(ECD),central corneal thickness(CCT),hexagonal cell ratio]and complications were compared between the two groups.Results Compared with the preoperative,the uncorrected visual acuity and intraocular pressure of the phacoemulsification group and the small incision group had statistically significant differences 8 weeks after surgery(P<0.05).At 8 weeks after surgery,there were no differences in uncorrected visual acuity,astigmatism and intraocular pressure between the two groups(P>0.05).The proportion of hexagonal cells in the phacoemulsification group decreased,and the difference was statistically significant(P<0.05).At 8 weeks after operation,the proportion of ECD and hexagonal cells in the small incision group was lower than that in the phacoemulsification group,and the CCT was higher than that in the phacoemulsification group,and the difference was statistically significant((P<0.05).The incidence of complications in the small incision group was significantly lower than that in the phacoemulsification group(P<0.05).Conclusion Both phacoemulsification and small incision chopping nucleus extraction for hard-nucleus cataract can effectively improve vision recovery and visual quality improvement.The effect degrees are similar to astigmatism and intraocular pressure.But risk of complications such as po

关 键 词：硬核白内障 超声乳化术 小切口碎核摘除术 视力 角膜内皮细胞 

分 类 号：R779.6[医药卫生—眼科]