反眉形巩膜隧道切口在囊外白内障摘除手术中的应用

Frown-shaped scleral tunnel incision in extracapsluar cataract extraction

目的:观察反眉形巩膜隧道切口在囊外白内障摘除手术中的临床疗效。方法:786例876眼白内障患者随机分为反眉形巩膜隧道切口组422例474眼和弧形巩膜切口组364例402眼,常规进行囊外摘除,前者切口不做缝合,后者缝合1～3针。结果:术后1wk最佳矫正视力,≥1.0者反眉形巩膜隧道切口组196眼占41.4%,弧形巩膜切口组对照组47眼占11.7%,0.5～1.0者反眉形巩膜隧道切口组230眼占48.5%,弧形巩膜切口组199眼占49.5%,0.1～0.5者反眉形巩膜隧道切口组48眼占10.1%,弧形巩膜切口组156眼占38.8%。反眉形巩膜隧道切口组术后矫正视力由于弧形巩膜切口组。术后1wk散光,反眉形巩膜隧道切口组0.56～1.40(平均0.98±0.42)D,弧形巩膜切口组0.76～4.00(平均2.38±1.62)D。两组有显著性差异(P<0.05)。术后1d角膜内皮损伤情况,反眉形巩膜隧道切口组透明者457眼占96.4%,损伤17眼占3.6%,弧形巩膜切口组透明者340眼占84.6%,损伤者62眼占15.4%,反眉形巩膜隧道切口组角膜内皮损伤的比例明显低于弧形巩膜切口组。结论:反眉形隧道切口不需缝合,术后矫正视力好,散光小,术中角膜内皮损伤轻,适合在无条件进行超声乳化折叠人工晶状体的基层医院推广应用。

AIM： To observe the clinical effect of frown-shaped scleral tunnel incision in extracapsluar cataract extraction. METHODS： A total of 786 cases （876 eyes） of cataract were randomly divided into two groups： The 422 cases （474 eyes） in Group A underwent frown-shaped scleral tunnel incision without suture, and the 364 cases （402 eyes） in Group B underwent regular arc-shaped scleral tunnel incision as controls with three stitches. RSULTS： At postoperative lwk, 196 eyes （41.4%） in group A and 47 eyes （11.7%） in group B had the best corrected visual acuity ≥ 1.0; 230 eyes （48.5%） in group A and 156 eyes （38.8%） in group B had that of 0.1-0.5; The astigmatism of group A was 0.56-1.40 （average 0.98±0.42）D and that of group B was 0.76-4.00 （average 2.38±1.62）D, with significant difference （P〈0.05）. At ld after surgery, 340 eyes （84.6%） had transparent cornea and 62 eyes （15.4%） had injured cornea in group A. CONCLUSION： Frown-shaped scleral tunnel incision can cause better postoperative correct visual acuity and light astigmatism without suture and few intra-operative injuries, and it is suitable for hospitals at grass roots lacking conditions for phaco-trabeculectomy with IOL implantation.