不同切口超声乳化术治疗白内障效果的比较

Comparison of effect of two different-incision phacoemulsifications in the treatment of cataract

摘要:

目的：比较同轴1.8mm微切口超声乳化术与标准同轴3.0mm超声乳化术治疗白内障的效果。

方法：选取2013-08/2015-08我院行白内障超声乳化吸除联合人工晶状体植入术的年龄相关白内障患者88例88眼，采用随机数字表法分为对照组采用标准同轴3.0mm小切口超声乳化术(44例，完成38例，脱落6例)和观察组采用同轴1.8mm微切口超声乳化术(44例，完成40例，脱落4例)，均联合人工晶状体植入术。记录两组术中有效超声时间、累计释放能量及手术前后最佳矫正视力，比较术前及术后1、7、30d角膜内皮细胞数、切口角膜厚度、角膜六边形细胞百分率、角膜散光变化。

结果：两组术中有效超声时间、累计释放能量比较差异无统计学意义(P>0.05)； 两组术后最佳矫正视力水平比较差异无统计学意义(P>0.05)； 两组术后1、7、30d角膜内皮细胞数、角膜六边形细胞百分率均下降，与治疗前相比差异有统计学意义(P<0.05)，但两组组间差异无统计学意义(P>0.05)，观察组术后30d切口角膜厚度低于对照组，差异有统计学意义(P<0.05)； 观察组术后1、7、30d角膜散光程度低于对照组，差异有统计学意义(P<0.05)。

结论：同轴微切口超声乳化术与标准同轴超声乳化术均可改善白内障患者视力水平，但前者可缩减轻角膜散光程度。

Abstract:

AIM: To explore and compare effect of coaxial micro-incision phacoemulsification and standard coaxial phacoemulsification in the treatment of cataract.

METHODS: A total of 88 patients(88 eyes)with senile cataract who underwent selective cataract ultrasonic emulsification resorption combined with intraocular lens implantation in the hospital from Aug. 2013 and Aug. 2015 were selected, they were divided randomly into the control group(44 cases, 38 cases completed, 6 cases dropped out)and the observation group(44 cases, 40 cases completed, 4 cases dropped out). The control group received standard coaxial 3.0mm small incision phacoemulsification, the observation group received coaxial 1.8mm micro-incision phacoemulsification. All patients were combined with intraocular lens implantation. Intraoperative effective ultrasonic time, cumulative release energy, best corrected visual acuity before and after surgery in the two groups were recorded, corneal endothelium cell population, incision corneal thickness, percentage of cornea hexagon cell, corneal astigmatism changes before the operation, 1d, 7d, 30d after the operation were compared.

RESULTS: There was no significant difference in intraoperative effective ultrasonic time, cumulative release energy in the two groups(P>0.05). There was no significant difference in postoperative best corrected visual acuity between the two groups(P>0.05). Corneal endothelium cell population, percentage of cornea hexagon cell 1d, 7d, 30d after the operation in the two groups were significantly decreased compared with those before the treatment(P<0.05), but there was no significant difference in the two groups(P>0.05). Incision corneal thickness 30d after the operation in the observation group was significantly lower than the control group(P<0.05). Degree of corneal astigmatism in the observation group 1d, 7d, and 30d after the operation were significantly lower than the control group(P<0.05).

CONCLUSION: Coaxial micro-incision phacoemulsification and standard coaxial phacoemulsification can improve visual acuity of cataract patients, but the former can reduce degree of corneal astigmatism.