高龄老年白内障透明角膜切口超声乳化联合硅凝胶人工晶状体植入术

Clinical observation of clear corneal incision phacoemulsification combined with silicone IOL implantation among senile cataract patients

目的：探讨75岁以上高龄老年白内障行透明角膜切口超声乳化联合疏水性硅凝胶人工晶状体植入术的安全性和疗效。方法：对随访1a资料完整75岁以上老年白内障透明角膜切口超声乳化联合疏水性硅凝胶人工晶状体植入病例65例（73眼）进行临床分析，并随机选择同期47～70岁年龄组老年白内障45例（56眼）作对照组。结果：术后两组所有患者视力有不同程度的提高，高龄组术后3mo，最佳矫正视力大于0．5的有62眼（占84．9％），与对照组比较差异无统计学意义（P〉0．05）。两组透明角膜切口术后1wk，1mo平均角膜散光度与术前比较均差异有统计学意义（P〈0．05）；而两组术后3mo平均角膜散光度与术前比较差异均无统计学意义（P〉0．05）。术中后囊膜破裂发生率及术后1a后囊膜混浊发生率两组差异无统计学意义（P〉0．05）；无其他严重手术并发症发生。结论：高龄老年白内障行透明角膜切口超声乳化术联合疏水性硅凝胶人工晶状体植入是安全有效的，术前需进行详细的全身及眼部检查，选择适合个体的麻醉方式。

AIM： To evaluate the effect and safety of the clear corneal incision phacoemulsification combined with hydrophobic silicone intraocular lens implantation in cataract patients aged over 75 years old. METHODS： A series of 73 eyes of 65 cases （ senile cataract patients） that received clear corneal incision phacoemulsification combined with hydrophobic silicone intraocular lens implantation were analyzed retrospectively, while 56 eyes of 45 cases （cataract patients aged between 47-70 years old） were studied as control. RESULTS： The best corrected visual acuity of both groups was improved postoperatively. Sixty-two senile eyes （84.9%） had achieved a BCVA of 10/20 or better at 3 months postoperatively. BCVA showed no statistically significant difference （P〉 0.05） between two groups. The mean corneal astigmatism of both groups presented a significant difference between preoperatively and first week postoperatively, as well as first month posto- peratively （ P 〈 0.05）, without statistical difference （ P 〉 0. 05） at the third month postoperatively. The incidence of posterior capsule rupture during operation and posterior capsule opacification at one year postoperatively showed no statistical difference （P 〉 0.05） between two groups. No severe complications occurred during the operation. CONCLUSION： The clear corneal incision phacoemulsification combined with hydrophobic silicone intraocular lens implantation in senile cataract patients is effective and safe. Topical and systemic examination will be made carefully before operation. Suitable anesthesia should be selected depending on the different patients.