黄斑裂孔手术和白内障手术同时进行或序贯进行的研究

Comparison of one step macular hole and cataract surgery with two step surgery

摘要:

目的：研究黄斑裂孔手术和白内障手术同时进行或序贯进行。

方法：在大不里士发起了一项对黄斑裂孔和白内障患者的临床试验，研究了黄斑裂孔手术和白内障手术同时进行或序贯进行对这些患者的影响。研究中22例患者(A组)首先进行超声乳化术及人工晶状体植入手术，1mo后同时进行23G微创玻璃体切除术和视网膜内界膜剥除术。21例患者(B组)进行白内障超声乳化人工晶状体植入手术联合23G微创玻璃体切除术以及视网膜内界膜剥除术。

结果：A组包括7例男性，15例女性； B组包括9例男性，12例女性(P=0.545)。A组和B组患者的平均年龄分别为66.63±4.75岁和67.71±4.99岁(P=0.472)。术后3mo，A组中2例患者，B组中5例患者黄斑裂孔未愈合(P=0.240)； A组1例患者，B组4例患者并发葡萄膜炎(P=0.185)； B组2例患者眼内压升高(P=0.233)； A组2例患者，B组4例并发后囊混浊(P=0.412)。

结论：两组相比，同时进行手术组产生并发症患者较多，但经统计学分析，术后疗效及并发症之间无统计学差异。

Abstract:

AIM: To compare one step macular hole and cataract surgery with two step surgery in patients with macular hole and cataract.

METHODS: In a clinical trial conducted on patients suffering from cataract with macular holes inTabriz, the effects of simultaneous surgery of macular hole and cataract performed on these patients were studied. In this study, 22 patients(Group A)were, first, undergone phacoemulsification and intraocular lens embedment, and one month later, 23-gauge pars plana vitrectomy together with the retinal internal limiting membrane(ILM)removal. Twenty-one patients(Group B)were undergone simultaneous phacoemulsification, intraocular lens embedment, 23-gauge pars plana vitrectomy, and the retinal ILM removal.

RESULTS: Group A was comprised of 7 males and 15 females, and Group B of 9 males and 12 females(P=0.545). The mean age of patients in Group A and B were 66.63±4.75 and 67.71±4.99y, respectively(P=0.472). Three months after surgeries were performed, the macular holes of 2 patients from Group A and 5 patients from Group B were open(P=0.240). Uveitis was observed in 1 patient from Group A and 4 from Group B(P=0.185). The increase of intraocular pressure(IOP)was merely observed in 2 patients from Group B(P=0.233). Posterior capsule opacification(PCO)was observed, three months after surgeries, in 2 patients from Group A and 4 from Group B(P=0.412).

CONCLUSION: The results suggested that, no significant difference existed between patients from the two groups in terms of outcome and postoperative complications, although,Group B patients, the recipients of simultaneous surgeries, experienced more complications compared to their Group A counterparts.