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[摘要]
目的:探讨小切口非超声乳化白内障手术中巩膜切口缝合两针与不缝合的疗效差异。
方法:对420例477眼白内障患者行小切口非超声乳化联合后房型人工晶状体植入术,一字形巩膜隧道切口大小为6~7mm,植入直径5.5mm硬性人工晶状体,切口对称缝合两针者205例230眼(A组),不缝合者215例247眼(B组),术后2d; 3mo观察术眼视力和角膜散光。
结果:术后2d,A、B二组裸眼视力或球镜矫正视力≥0.5者分别为193眼(83.9%)和190眼(76.9%),术后3mo,A、B二组裸眼视力或球镜矫正视力≥0.5者分别为205眼(89.1%)和198眼(80.2%),两组病例不同时期视力差异均有统计学意义(P<0.05); 术后2d; 3mo,A组的平均角膜散光分别为1.53±0.59,1.05±0.43D,B组平均角膜散光分别为1.85±0.97,1.31±0.65D,两组病例术后不同时间平均角膜散光度差异均有统计学意义(P<0.01); A组病例术后无出现切口渗漏、浅前房、虹膜膨出的并发症,B组病例术后有3眼(1.21%)出现切口轻度渗漏、前房稍浅,4眼(1.62%)术后第1d出现上方虹膜膨出并嵌顿于巩膜切口。
结论:小切口非超声乳化白内障手术巩膜切口缝合两针者较不缝合者术后视力好,角膜散光小,手术更安全。
[Key word]
[Abstract]
AIM: To compare the effectiveness of incision suture and no suture in small incision non-phacoemulsification cataract surgery.
METHODS: Totally 420 patients 477 eyes with cataract underwent small incision non-phacoemulsification cataract surgery through sclera tunnel incision(6-7mm)and implanted rigidly artificial crystal(The diameter was 5.5 mm), the incisions of 205 patients 230 eyes(group A)with cataract were symmetrically sutured two needles, the incisions of 215 patients 247 eyes(group B)with cataract were not sutured. Bare eye vision and corneal astigmatism were observed at postoperative 2 days and 3 months.
RESULTS: At postoperative 2 days, bare eye sight or the best-corrected visual acuity(BCVA)through spherical mirrors ≥0.5 was in193 eyes(83.9%)in group A and in 190 eyes(76.9%)in group B, at postoperative 3 months, bare eye sight or BCVA by spherical mirrors ≥0.5 was in 205 eyes(89.1%)in group A and in 198 eyes(80.2%)in group B, there was statistical difference in vision changes at postoperative 2 days and 3 months between two groups(P < 0.05); At postoperative 2 days, mean corneal astigmatism was 1.53±0.59D in group A and 1.85±0.97D in group B, at postoperative 3 months, mean corneal astigmatism was 1.05±0.43D in group A and 1.31±0.65D in group B, there was statistical difference in mean corneal astigmatism at postoperative 2 days and 3 months between two groups(P < 0.01); In group A there were no postoperative complications such as incision leakage, shallow anterior chamber, iris encephaloceles or iris embedded in sclera incision, etc; but in group B there were 3 eyes(1.21%)with incision leakage and shallow anterior chamber after operation and 4 eyes(1.62%)with iris encephaloceles and iris embedded in sclera incision at postoperative one day.
CONCLUSION: Incision suture in small incision non-phacoemulsification cataract surgery has better visual recovery, less corneal astigmatism and more safe than that no suture.
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