完整撕囊联合劈核小切口白内障囊外摘除术在防盲手术中的应用

Application of orbicular capsulotomy and nucleus division in small incision ECCE for cataract surgery in visual rehabilitation

目的:探讨表面麻醉下完整撕囊联合劈核小切口白内障囊外摘除术在眼科大规模防盲手术中应用的初步效果。方法:四川省贫困白内障患者716例716眼,分为常规组387例387眼及劈核组329例329眼,分别在表面麻醉下行完整撕囊白内障囊外摘除、人工晶状体植入术及完整撕囊联合劈核小切口白内障囊外摘除、人工晶状体植入术。记录术前、术后1d最佳矫正视力,脱盲率、脱残率及术后并发症。采用SAS8.2统计软件对结果进行统计学分析。结果:术后1d最佳矫正视力:常规组是0.517,劈核组是0.683,差异有统计学意义(P<0.05)。脱盲率:常规组96.9%,劈核组97.3%,差异无统计学意义(P>0.05)。脱残率:常规组88.9%,劈核组92.7%,差异无统计学意义(P>0.05)。结论:表面麻醉下完整撕囊联合劈核小切口白内障囊外摘除术适宜在眼科大规模防盲中广泛应用。

AIM： To discuss the primary effects of orbicular capsulotomy and nucteus division in small incision extracapsular cataract extraction （ECCE） under topical anesthesia for large scale cataract surgery in visual rehabilitation. METHODS： Seven hundred and sixteen Sichuan needy patients（716 eyes） were divided into routine group （387 patients, 387 eyes） and nucleus-chopping group （329 patients,329 eyes）. ECCE and intraocular lens （IOL） implantation with orbicular capsulotomy were performed on routine group under topical anesthesia. ECCE, IOL implantation with orbicular capsulotomy, manual nucleus division and small incision technique were performed on nucleus-chopping group under topical anesthesia. The best corrected visual acuity （BCVA）, off-blind probabilities, off-remnant probabilities and complications preoperation and the first day post-operation were noted. And the results were analyzed statistically with software SAS8.2. RESULTS： The BCVA of the first postoperative day： routine group was 0. 517; nucleus-chopping proup was 0. 683 （ P 〈 0.05） ; and the difference was significant. Offblind probability： routine group was 96. 9%; nucleuschopping goup was 97.3% （ P 〉 0.05） ; and the difference was not significant. Off-remnant probability： routine group was 88.9% ; nucleus-chopping proup was 92.7% （P〉0.05） ;and the difference was not significant. CONCLUSION： The orbicular capsulotomy and nucleus division in small decision ECCE under topical anesthesia seems to be effective in large scale blindness prevention.