小切口非超声乳化人工晶状体植入治疗老年性白内障40例临床观察

Clinical observation of 40 cases of small incision non-phacoemulsification and intraocular lens implantation in senile cataract

目的:探讨非超声乳化小切口囊外白内障摘出人工晶状体植入术治疗老年性白内障的临床效果。方法:对40例40眼老年性白内障患者采用巩膜隧道式小切口白内障囊外摘除术,同时植入后房型人工晶状体。观察术后视力恢复、散光情况及并发症。结果:术后随访1～36mo,裸眼或矫正视力<0.5者1例(2.5%),0.6～1.0者18例(45.0%),1.2～1.5者21例(52.5%)。术前、术后1mo和3mo平均散光分别为(0.90±0.81),(0.95±0.65)D和(0.93±0.60)D,术后1mo和3mo与术前比较都无显著差异(P>0.05)。主要并发症有角膜水肿、前房炎症反应。无娩核困难、后囊膜破裂、玻璃体脱出、人工晶状体植入失败和虹膜损伤等并发症。结论:小切口非超声乳化囊外白内障摘出人工晶状体植入术设备简单,操作易于掌握,切口小、创伤小、术后视力恢复良好、角膜散光小、并发症少。效果好、安全可靠、经济实惠,适于基层医院开展。

AIM： To explore clinical effects of the non-phacoemulsification small incision extracapsular cataract extraction and intraocular lens implantation in the treatment of senile cataract. METHODS： Forty eyes of 40 cases with senile cataract were treated with scleral tunnel incision extracapsular cataract extraction, and posterior chamber intraocular lens implantation. Postoperative visual acuity, astigmatism and complications were observed. RESULTS： With follow-up of 1-36 months, naked eye, or corrected vision was ﹤0.5 in 1 case （2.5%）, 0.6-1.0 in 18 cases （45.0%）, 1.2-1.5 in 21 cases （52.5%）. 1 month and 3 months before and after operation, mean astigmatism was （0.90±0.81） D, （0.95±0.65） D and （093±0.60） D respectively and compared with the preoperative data, mean astigmatism 1 month and 3 months after operation had no significant difference （P〉0.05）. The major complications are corneal edema, anterior chamber inflammation. No nuclear expulsion difficulties, posterior capsule rupture, vitreous prolapse, intraocular lens implantation failure or complications such as iris damage occurred. CONCLUSION： Small incision non-phacoemulsification extracapsular cataract extraction and intraocular lens implantation need simple equipment and operation is easy to master.With small incision, less trauma, good restored visual acuity, small corneal astigmatism and few complications,it＇s effective, safe, reliable, affordable and suitable for primary hospital.