陡峭轴切口与颞侧角膜切口在年龄相关性白内障患者超声乳化术中的对比研究

Comparative Study of Steep Axial Incision and Temporal Corneal Incision in Phacoemulsification of Patients with Age-related Cataract

目的探讨陡峭轴切口与颞侧角膜切口在年龄相关性白内障患者超声乳化术中的应用。方法选取作者医院2018-09/2019-09月期间收治的70例年龄相关性白内障患者为研究对象,根据随机数字表法将患者分为陡峭轴切口组(n=35)和颞侧角膜切口组(n=35),陡峭轴切口组采用陡峭轴切口超声乳化+人工晶状体植入术治疗,颞侧角膜切口组采用颞侧角膜切口超声乳化+人工晶状体植入术治疗。比较两组患者术前、术后1周、术后1个月裸眼视力(uncorrected visual acuity,UCVA)、最佳矫正视力(best corrected visual acuity,BCVA)、角膜散光度、第1次泪膜破裂时间(non-invasive first tear film breakup time,NIBUTf)、非侵入性平均泪膜破裂时间(non-invasive average tear film breakup time,NIBUTav)及泪河高度(non-invasive keratograph tear meniscus height,NIKTMH),泪液总蛋白水平及角膜敏感度。结果术后1个月,陡峭轴切口组UCVA优于颞侧角膜切口组,角膜散光度低于颞侧角膜切口组,NIBUTf、NIBUTav长于颞侧角膜切口组,NIKTMH高于颞侧角膜切口组,角膜敏感度高于颞侧角膜切口组,组间比较差异均有统计学意义(P<0.05);两组患者术前、术后1周、术后1个月的BCVA、泪液总蛋白水平比较,差异无统计学意义(P>0.05)。结论陡峭轴切口与颞侧角膜切口超声乳化术均能有效改善年龄相关性白内障患者BCVA,但在UCVA、泪膜稳定性、角膜敏感度方面,陡峭轴切口治疗更有优势。

Objective To investigate the application of steep axis incision and temporal corneal incision in phacoemulsification in patients with age-related cataract.Methods A total of 70 patients with age-related cataract in author’s hospital from September 2018 to September 2019 were enrolled and randomly divided into steep axis incision group(n=35)and temporal corneal incision group(n=35),and each group with 35 patients.The patients in the steep axis incision group were treated with steep axis incision phacoemulsification and intraocular lens implantation,and the temporal corneal incision group were treated with temporal corneal incision phacoemulsification and intraocular lens implantation.The uncorrected visual acuity(UCVA),the best corrected visual acuity(BCVA),corneal astigmatism,the non-invasive first tear film breakup time(NIBUTf),the non-invasive average tear film breakup time(NIBUTav),the non-invasive keratograph tear meniscus height(NIKTMH),total tear protein level and corneal sensitivity were compared between the two groups before operation,1 week and 1 month after operation.Results Compared with temporal corneal incision group,the UCVA in the steep axial incision group was better;the corneal astigmatism was lower;the NIBUTf and NIBUTav were longer;the NIKTMH was higher and the corneal sensitivity was higher after one month operation(P<0.05).There was no significant difference in the levels of BCVA and total tear protein between the two groups before operation,1 week and 1 month after operation(P>0.05).Conclusion Both steep axis incision and temporal corneal incision phacoemulsification can effectively improve BCVA of patients with age-related cataract,but steep axis incision has more advantages in UCVA,tear film stability and corneal sensitivity.