伴有粘连性小瞳孔的硬核白内障手术方法临床分析

Clinical analysis of different surgical procedures for hard nuclear cataract with adhesive small pupils

目的:对伴有粘连性小瞳孔的硬核白内障采取不同手术方法,比较其术后散光及角膜内皮细胞丢失率,对手术方法进行评价。方法:选取伴有粘连性小瞳孔的晶状体核硬度≥ⅡI级(LOCSⅡ分级标准)的白内障患者45例(46眼),随机分为两组,分别采用超声乳化组和小切口非超声乳化白内障摘除联合后房型人工晶状体植入术,比较术后角膜散光和角膜内皮细胞丢失率。结果:术后1mo时超声乳化组和小切口非超声乳化组角膜散光的差异无显著性;术后1wk时小切口非超声乳化组角膜内皮细胞丢失率低于超声乳化组,差异有显著性(P<0.05)。结论:对于伴有粘连性小瞳孔的硬核白内障,小切口非超声乳化白内障摘除手术更安全、实用。

AIM： To evaluate different surgical procedures for hard nuclear cataract with adhesive small pupils by comparing postoperative astigmatism and corneal endothelial cell loss rate.METHODS： A total of 45 cases （46 eyes） of hard nuclear cataract （Grade Ⅲ according to LOCS Ⅱ standard） with adhesive small pupils were randomly divided into phacoemulsification group and small incision non- phacoemulsification group. Posterior intraocular lens implantation was conducted in small incision non-phacoe- mulsification group as well. Postoperative astigmatism and corneal endothelial cell loss rate were compared between the two groups.RESULTS： One month after surgery, phacoemul- sification group had a similar incidence of postoperative astigmatism compared with small incision nonphacoemul- sification group, showing no significant difference. One week after surgery, small incision non-phacoemulsifi- cation group had a lower loss rate of corneal endothelial cells than phacoemulsification group, and there was a significant difference （ P〈 0.05）.CONCLUSION： Non-phacoemulsification small incision cataract surgery can be used safely and effectively for patients of hard nuclear cataract with adhesive small pupils.