白内障超声乳化术治疗Ⅳ级核白内障的效果

CLINICAL EFFECT OF PHACOEMULSIFICATION ON GRADE Ⅳ HARD-NUCLEUS OF CATARACT

目的 观察白内障超声乳化术治疗Ⅳ级核白内障的效果。方法 选择我院2006年10月～2007年6月收治的Ⅳ级核白内障病人72例（72眼）,随机分为两组,Ⅰ组38例（38眼）行超声乳化白内障吸除术,Ⅱ组34例（34眼）行改良小口白内障囊外摘除术,均联合人工晶状体植入术。分别于术后1 d、1周、1月对两组术眼非校正远视力（UCDVA）、角膜散光度数、角膜内皮细胞数进行比较。结果 术后1 d两组UCDVA差别有统计学意义（t=2.34,P〈0.05）,术后1周、1月两组比较差别均无统计学意义（P〉0.05）。术后1月时两组角膜散光度数比较差别无统计学意义（P〉0.05）。术后1月时两组角膜内皮细胞密度同术前比较,Ⅰ组差别无统计学意义（P〉0.05）,Ⅱ组有统计学意义（t=4.73,P〈0.05）,两组间比较差别亦有显著性（t=2.95,P〈0.05）。两组术后均无角膜内皮失代偿症状出现。结论 超声乳化术治疗Ⅳ级核白内障,术后可获得良好UCDVA,同改良小切口囊外摘除术比较,病人术后角膜内皮细胞损失较少,该方法 对于Ⅳ级核白内障仍为安全有效的治疗方式。

Objective To observe the clinical effect of phacoemulsification on grade Ⅳ hard-nucleus of cataract. Methods Seventy-two hard-nucleus grade Ⅳ cataract were divided into two groups： group 1（38 eyes）, treated with phacoemulsification; group 2 （34）, treated with modified small-incision extracapsulor cataract extraction. Implantation of the IOL was done in both groups, The uncorrected distant visual acuity （UCDVA）, corneal astigmatism and the amount of the corneal endothelium were observed on the first day, first week and first month after surgery. Results The difference of values of UCDVA was significantly different between the two groups on the first pOst-operative day （t= 2.34,P〈0.05）, while no significant difference was found on the first week and first month after the operetion （P〉0.05）. Similar results were observed on the cornea astigmatism between two groups one month after the operation （P〉0.05）. Significant differences in the numbers of cornea endothelium were only noticed in group 2 （t： 4.73, P〈0.05） compared with one month after and before the operation. Symptom of cornea endothelium decompensation was not found in all the patients. Conclusion Patients treated with phacoemulsification can get fine UCDVA. Phacoemulsification is a safe and efficient method for grade Ⅳ hard-nucleus of cataract.