双手微小切口白内障超声乳化术的临床疗效观察

A clinical control study on bimanual microphacoemulsification

目的探讨双手微小切口白内障超声乳化吸除术的临床疗效。方法将患者分为两组:对照组使用常规超声乳化吸除术,研究组使用双手微小切口白内障超声乳化吸除术,观察术中平均超声乳化能量、时间、术后视力和手术并发症,并分析对比术后第1周、第1个月及第3个月的角膜内皮计数。结果两组病例术中超声乳化能量及时间差异有显著性(P<0.05),研究组平均超声能量为11.5%,平均超声时间为(0.68±0.62)min,术后第1天、第1周及第1个月时,裸眼视力≥0.5的术眼分别占51.85%、81.48%及90.47%,术后第1个月最佳矫正视力≥0.5和0.8者占88.98%及74.07%。所有术眼术中前房稳定,无切口热损伤,术后并发症主要为后囊破裂2眼(占3.70%),轻度虹膜损伤4眼(占7.40%);术后第1周,研究组平均角膜内皮密度明显高于对照组,术后第1个月及第3个月平均角膜内皮密度差异则无显著性。结论双手微小切口白内障超声乳化吸除术是一种新型的手术方法,具有安全、有效、微创的临床特点。

Objective To evaluate the outcome of bimanual microphacoemulsification. Methods One hundred and four cases of patients with senile cataract were randomly divided into two groups： a control group and a study group. Regular phacoemulsification was performed on the control group and microemulsification on the study group, The study parameters included phacoemulsification energy, exposure time, intraoperative complications and early postoperative outcome. Statistics was used to compare the mean endothelium count. Results These was a statistically significant difference between the two groups for average, energy and exposure, time of phacoemulsification. The mean of the phacoemulsification energy was 11.5 % and exposure time was （0.68±0.62）min. A visual acuity of 0.5 or better was obtained in 51.85% , 81.48% and 90.74% of the patients on the first day, on the first week and on the lust month, respectively, after surgery. A corrected visual acuity of 0.5 was obtained in 74.07% of all treated eyes one month postoperatively. The formation of the anterior chamber was successfully maintained in every case. The main complications from surgery were the rupture of the posterior capsule and injury to the iris. None of the cases showed heat injury from the ineision. Them was a statistically significant difference between the two groups in mean endathelium count one week after surgery, whereas these was no statistical difference 1 month and 3 month postoperatively. Conclusion Bimanual is feasible, safe and effective surgery for the cataract patient.