不同切口超声乳化联合MI60型人工晶状体植入术对白内障患者视觉质量的影响

Clinical evaluation of two different-incision phacoemulsifications

摘要:

目的：比较超声乳化同轴3.0mm切口与2.2mm切口联合MI60型人工晶状体植入对白内障患者视觉质量的影响。

方法：前瞻性病例对照研究。采用随机数字表法，将实施超声乳化年龄相关性白内障手术的患者100例100眼随机分为两组，传统3.0mm切口组50例50眼， 2.2mm切口组50例50眼。观察患者术后1wk，3mo的最佳矫正视力(BCVA)、对比敏感度(CS)及手术源性散光(SIA)。并由2位工作人员在末次随访完成VF和QOL问卷调查。

结果：术后1wk，3mo，两组矫正视力差异均无统计学意义(t=-1.366、-1. 688，P=0. 148、0.107)。2.2mm切口组在夜视(3、6c/d)及夜视加周边眩光(1.5、3、6c/d)条件下，术后1wk对比敏感度值优于3.0mm切口组，差异有统计学意义(P<0.05)。术后3mo两组对比敏感度差异无统计学意义(P>0.05)。术后1wk， 3mo，2.2mm切口组SIA分别为0. 46±0.29、0.43±0.26D； 3.0mm切口组SIA分别为1.55±0.59、 0.89±0.28D，两组差异具有统计学意义(t=-7.348、-3. 788，P=0.000、 0.000)。两组病例平均VF得分差异无统计学意义，但视觉适应一项得分2.2mm切口组优于3.0mm切口组，差异具有统计学意义(t=-3.348，P<0.05)。

结论：同轴2.2mm切口超声乳化联合人工晶状体植入较同轴3.0mm切口治疗年龄相关性白内障手术相比，能有效减少SIA，且视觉适应性更优，具有更佳的视觉质量。

Abstract:

AIM: To study and compare the outcomes of coaxial 2.2 mm phacoemulsiflcation with conventional coaxial 3 mm small-incision cataract surgery.

METHODS:A randomized prospective study was conducted on 100 patients with age-related cataract: coaxial 2.2 mm micro-incision cataract surgery was performed in 50 cases(50 eyes), and coaxial 3 mm small incision cataract surgery was performed in 50 cases(50 eyes). Statistical analysis was takenwith the data of the two groups. Visual acuity, VF and QOL were compared at intervals of 1wk and 3mo after surgery. In addition, surgically induced astigmatism(SIA)was analyzed. Statistic analysis was taken by Student's t-test and Chi-square test.

RESULTS: There was no significant difference on BCVA(t=-1.366, -1.688; P=0.148, 0.107)between these two groups. One week and 3mo after the surgery, SIA was(0.46±0.29)D,(0.43±0.26)D in the 2.2 group; and(1.55±0.59)D,(0.89±0.28)D, in 3.0 group. The differences between these two groups were statistically significant(t=-7.348, -3.788; P=0.000, 0.000)There were no statistically significant differences on VF scores between two group, while it's got a better score in 2.2 groups on vision adaptation.(t=-3.348, P<0.05).

CONCLUSION:Coaxial 2.2mm micro-incision cataract surgery could significantly reduce SIA and obtain morestable status of VF and QOL. This suggests that the coaxial 2.2 phacoemulsification surgery implanted AkreosMI60 intraocular lens could get earliervisual rehabilitation postoperation.