高度近视合并白内障的超声乳化术疗效分析

Clinical effects of phacoemulsification and IOL implantation for cataract with high myopia

目的观察白内障超声乳化摘除术治疗高度近视合并白内障的临床疗效。方法对高度近视合并白内障患者68例(76只眼)(Ⅰ组),与同期进行的单纯老年性白内障76例(84只眼)(Ⅱ组),进行超声乳化吸除联合人工晶状体植入术,观察对比术中超声能量及时间、术中术后并发症、术后视力及角膜内皮细胞变化。结果术中使用超声能量及时间两组间无差异,术后视力Ⅰ组>0.3占77.6%,Ⅱ组>0.3占96.4%。Ⅰ组后囊膜破裂2只眼(2.6%)。后囊膜不同程度混浊Ⅰ组15只眼(19.7%),其中5只眼(6.6%)行YAG激光后囊膜切开,Ⅱ组11只眼(13.1%),其中3只眼(3.6%)行YAG激光后囊膜切开。术后3个月两组角膜内皮细胞密度分别为(2239.27±336.02)个/mm2和(2173.51±352.39)个/mm2,两组间差异无显著意义(t=1.294,P>0.05)。两组术后3月与术前比较差异均有非常显著意义(t=3.633,t=3.482,P<0.01)。结论超声乳化白内障摘除术治疗高度近视合并白内障可获得良好的手术效果,是一种安全理想的手术方法,但要求较高的手术操作技巧。

Objective To evaluate the clinical effects of phacoemulsification and IOL implantation for cataract with high myopia. Methods 68 eases （76 eyes ） （ group I ） with cataract and high myopia and 76 easas （84 eyes ） （ group Ⅱ） of senile cataract had undergone phacoemulsification and IOL implantation respectively. Intraoperative ultrasound energy and time, postoperative compl;eations, visual aeuity and the changes of corneal endothelial cell were observed between two groups. Results There was no significant difference of the intraoperative ultrasound energy and time between two groups. Postoperative visual acuity better than 0.3 accounted for 77.6% in group Ⅰ, 96.4% in group Ⅱ. Posterior capsular rupture oecured in 2 eyes （2.6% ） of group Ⅰ Posterior capsular opacification occurred in 15eyes （19.7% ） of group Ⅰ , 1 leyes （ 13.1% ） of group Ⅱ. YAG laser eapsulotomy was done in 5 eyes （ 6.6% ） of group Ⅰ, lleyes （ 13.1% ） of group Ⅱ. 3 month after operation corneal endothelial cell density in two groups were 2239.27± 336.02/mm^2 and 2173.51 ± 352.39/ mm^2 respectively. There was no significant difference of the corneal endothelial cell density between two groups （ T = 1,294, P 〉 0.05 ）. There was difference significantly of corneal endothelial cell density between before operation and 3 month after operation in two groups（ T = 3. 633, T = 3. 482, P 〈 0.01 ）. Conclusion Phacoemulsification and IOL implantation is an effective and ideal method for cataract with high myopia. But perfect surgical techniques are necessary.