小切口无缝线白内障摘出联合人工晶体植入术的研究

A study on small incision sutureless cataract extraction intraocular lens implantation

目的对比分析小切口无缝线白内障摘出术（SICS）、白内障囊外摘出术（ECCE）、晶状体超声乳化术（Phaco）三种手术方法的效果。方法2120例2225眼老年性白内障随机分成三组，分别采用SICS、ECCE、Phaco手术，均一期植入人工晶体。对比观察术后1周视力、散光及并发症。结果术后1周裸眼视力≥0．6者，SICS组多于ECCE组，差异有统计学意义（P〈0．05）；SICS组与Phaco组比较，差异无统计学意义（P〉0．05）。术后1周检查手术源性散光：SICS组低于ECCE组，P〈0．05；SICS组与Phaco组比较，P〉0．05。术中后囊膜破裂合并玻璃体脱出：SICS组42眼，ECCE组29眼，Phaco组38眼。术后第1天角膜水肿：SICS组64眼，ECCE组39眼，Phaco组74眼。结论SICS疗效优于ECCE，SICS疗效与Phaco相比差异无统计学意义。SICS效果好、成本低，适合基层医院推广普及。

Objective To compare the efficacy and surgical after cataract surgery by small incision sutureless cataract surgery（SICS ）, conventional extracapsular cataract extraction（ ECCE ） and phacoemulsifcation （Phaco）. Methods Two thousand two hundred and twenty-five eyes of cataract were randomized to undergo SICS （ SICS group）, ECCE （ ECCE group）and Phaco （Phaco group）with intraecular lens （ non-foldable） implantation. The visual acuity ,surgically induced astigmatism and complications were compared after surgery. Results The postoperative visual acuity was checked one week after operation, For better uncorrected visual acuity （≥0.6）, there was significant statistic difference between SICS group and ECCE group （P 〈 0.05）,but there was no significant difference between SICS group and Phaco group （P 〉 0.05）, The surgically induced astigmatism was calculated one week after surgery, There was significant statistic difference between SICS group and ECCE group （P 〈 0.05）, but there was no significant difference between SICS group and Phaco group （P〉 0.05）. During surgery,posterior capsular ruptured and vitreous came out in 42 eyes in SICS group,29 eyes in ECCE group and 38 eyes in Phaco group. Moderate corneal edema happened in 64 eyes in SICS group,39 eyes in ECCE group and 74 eyes in Phaco group. Conclusions SICS is effective and economical which is the most suitable surgical method for rural and basic hospital.