OASIS内置式虹膜扩张器在小瞳孔白内障超声乳化术中的应用

Effect of built-in type OASIS iris expander in phacoemulsification surgery for cataract with small pupil

摘要:

目的：观察OASIS内置式虹膜扩张器在小瞳孔白内障超声乳化术中的应用效果。

方法：选择2016-01/2017-10在我院接受治疗的小瞳孔白内障患者44例，随机分为对照组(22例31眼)和观察组(22例30眼)，对照组采用劈核器和晶状体调位钩手动撕开扩张瞳孔行常规白内障超声乳化手术治疗，观察组在术中植入OASIS内置式虹膜扩张器扩大瞳孔行常规白内障超声乳化手术治疗，对两组患者手术前后最佳矫正视力(BCVA)、角膜内皮细胞计数、瞳孔直径及眼压变化情况进行对比分析，评价OASIS内置式虹膜扩张器的应用效果。

结果：术后1mo，两组患者BCVA 较术前均显著改善，且观察组患者BCVA(0.09±0.04)显著优于对照组(0.20±0.03)，差异均有统计学意义(P<0.05)。术后1mo，两组患者角膜内皮细胞计数均较术前明显减少，但观察组患者角膜内皮细胞计数(2455.77±52.98个/mm²)显著高于对照组(2298.94±49.12个/mm² )，差异均有统计学意义(P<0.05)。术后1mo，两组患者瞳孔直径较术前均有所扩大(P<0.05)，且观察组患者瞳孔直径(3.52±1.14mm)大于对照组(3.15±1.02mm)； 术后6mo，两组患者瞳孔直径较术后1mo均显著扩大(P<0.05)，但两组间比较，差异无统计学意义(P>0.05)。术后1mo，两组患者眼压较术前均有所降低(P<0.05)，且观察组眼压(13.40±1.73mmHg)低于对照组(13.93±1.98mmHg)； 术后6mo，两组患者眼压均低于术后1mo(P<0.05)，但两组间比较差异无统计学意义(P>0.05)。

结论：OASIS内置式虹膜扩张器用于小瞳孔白内障超声乳化术中可提高术后最佳矫正视力、降低眼压、扩张瞳孔直径，应用效果较好。

Abstract:

AIM: To observe the effect of built-in type OASIS iris expander in phacoemulsification surgery for cataract with small pupil.

METHODS: Totally 44 cataract patients with small pupil were treated in our hospital from January 2016 to October 2017 were randomly divided into the control group(22 cases, 31 eyes)and the observation group(22 cases, 30 eyes). The patients in control group was treated by conventional phacoemulsification surgery, within surgery the small pupils were dilated by cleavage and lens position hook; the patients in observation group use OASIS iris expander within surgery. The best corrected visual acuity(BCVA), corneal endothelial cell counts, pupil size, intraocular pressure(IOP)of two groups before and after surgery were compared and analyzed, and the application effect of built-in type OASIS iris expander was evaluated.

RESULTS: At 1mo after operation, the BCVA of the two groups were significantly improved, and the BCVA of the observation group(0.09±0.04)was significantly better than that of the control group(0.20±0.03), the difference was statistically significant(P<0.05). At 1mo after operation, the corneal endothelial cell counts of the two groups were significantly decreased, but the corneal endothelial cell counts of the observation group(2455.77±52.98/mm²)were significantly higher than those of the control group(2298.94±49.12/mm²), the difference was statistically significant(P<0.05). At 1mo after operation, the pupil diameter of the two groups was enlarged(P<0.05), and the pupil diameter of the observation group(3.52±1.14mm)was larger than that of the control group(3.15±1.02mm, P>0.05). At 6mo after operation, the pupil diameter of the two groups was significantly enlarged(P<0.05), but there was no significant difference in the pupil diameter between the two groups(P>0.05). At 1mo after operation, intraocular pressure in both groups was lower than that before operation(P<0.05), and the intraocular pressure in observation group(13.40±1.73mmHg)was lower than that in control group(13.93±1.98mmHg, P>0.05). At 6mo after operation, intraocular pressure in both groups was lower than that before operation and 1mo after operation(P<0.05), but there was no significant difference in intraocular pressure between the two groups at 6mo after operation(P>0.05).

CONCLUSION: The OASIS built-in iris dilator can improve the best corrected visual acuity, reduce intraocular pressure and expand pupil diameter in small pupil phacoemulsification.