双手法微切口白内障超声乳化手术的初步临床观察

Preliminary clinical report of bimanual mlcro-incision phacoemulsification

目的探讨双手法微切口白内障超声乳化手术的疗效。方法将40例（40眼）年龄相关性白内障患者随机分为两组,每组20例（20眼）,分别行双手法微切口白内障超声乳化摘除并人工晶体植入术及常规的白内障超声乳化摘除并人工晶体植入术。观察两组术中有效超声乳化时间、术后视力和角膜屈光状态变化等至3个月到6个月。结果双手法组术中有效超声乳化时间（EPT）为0.9～22.1s,平均5.91±4.70s。术后1周平均散光度数为0.65±0.24D,术后1个月为0.67±0.22D,术后1个月角膜内皮细胞计数为2590.6±243个/mm^2。常规组术中有效超声乳化时间为1.2～23s,平均7.1±2.30s。术后1周平均散光度为2.05±0.54D,术后1个月为1.45±0.75D。术后1个月角膜内皮细胞计数为2623±287个/mm2。两组患者术后手术性散光1天时差异有统计学意义（P〈0.01）;术后1周对比仍有统计学意义（P〈0.05）;1个月时无统计学意义（P〉0.05）;术后矫正视力1周,1个月,3个月两组均有明显提高,比较视力变化无统计学意义（P〉0.05）。结论双手微切口超声乳化白内障吸除术可安全、有效地通过〈1.9mm的切口摘除白内障并植入人工晶体,术后早期视功能恢复优于常规白内障超声乳化手术。

Objective To evaluate the postoperative results of bimanual phacoemulsification. Methods The preliminary clinical study included 40age-related cataract eyes which were divided into two groups randomly. Group Ⅰ （20 cases,20 eyes）were received cataract extraction through the 1.2mm incision. Acri.Smart 36A IOLs were implanted into the eyes through 1.9mm incision. Group Ⅱ（20cases,20eyes） were received normal phacoemulsification and Acrysof Nature IOLs were implanted into the eyes through 3.0mm incision. Results Group Ⅰ the mean effective phacoemulsification time（EPT） was 5.91 ±4.70 seconds, while that in Group Ⅱ was 7.1 ＋ 2.30seconds. In the first postoperative day, the surgical induced astigmatism （SIA） was 0.75 ± 0.26D and 2.28 ± 0.43D in Group Ⅰand Group Ⅱ.There is significant difference statistically （P 〈 0.01）. In the 7th postoperative day, SIA was0.65 ± 0.24D in Group I and 2.05 ± 0.54D in Group Ⅱ, There is still difference statistically（P 〈 0.05）.But one month after surgery, the SIA of both groups is 0.67 ± 0. 22D and 1.45 ± 0.75D, there is no statistical difference（P 〉 0.05）. Conclusions Bimanual microincision phacoemulsification and implantation of the Acri.smart IOL is a feasible, secure, and effective surgery for cataract extraction through a sub - 1.9mm clear cornea incision and a better choice of cataract surgery.