免水分离超声乳化白内障摘除人工晶体植入术临床观察

Clinical Observation in Free-water Separation of Phacoemulsification Cataract Extraction and Intraocular Lens Implantation

目的探讨免水分离术在超声乳化白内障摘除术中临床应用的有效性和安全性。方法对比观察2008年6～12月2组超声乳化白内障摘除联合人工晶体植入病例,320例进行常规水分离术(对照组),352例免水分离(观察组)。结果 (1)Ⅱ级核、Ⅲ级核IV级核、平均超声时间对照组分别为(15.2±6.1)s,(28.9±7.3)s,(46.5±7.9)s,观察组分别为(15.1±4.6)s、(29.3±6.6)s、(45.5±8.9)s,2组平均超声时间差异无显著意义(t=1.412、-1.421、1.351,P=0.171、0.159、0.197);(2)术后第1天角膜水肿(轻中重度)发生率对照组分别为25.6%,10.9%,4.7%,观察组分别为25.7%,9.5%,4.8%,2组无显著性差异(t=-1.221、1.572、-1.415,P=0.091,0.142,0.164);(3)术后1周的矫正视力≥0.5,对照组289例,观察组301例,无显著性差异。无一例发生晶体核坠入玻璃体腔。结论免水分离超声乳化白内障摘除术联合人工晶体植入术效果良好,可减少操作步骤,手术更加简便、快速,并可避免水分离的相关并发症。

Objective To discuss the effectiveness and safety of the free-water separation technique in phacoemulsification cataract surgery.Methods The observation on 352 cases of water-free separation of phacoemulsification cataract extraction and intraocular lens implantation and 320 cases of water separation during June to December in 2008.Results（1） the average time of gradeII,gradeIII,gradeIV for one ultrasound group is（15.2±6.1）s,（28.9±7.3）s,（46.5±7.9）s,the other is（15.1±4.6）s、（29.3±6.6）s、（45.5±8.9）s,the two group results have no meaning（t =1.412、-1.421、1.351,P=0.171、0.159、0.197）（2）the corn edma after a day is 25.6%,10.9%,4.7% and 25.6%,9.6%,4.8% in the other group,the results have no meaning（t =-1.221、1.572、-1.415,P=0.091,0.142,0.164）.（3）corrected visual acuity≥0.5 were 289 cases a week after surgery and 301 cases in the other group,without a case of len crashed into the vitreous cavity.Conclusion free-water separation phacoemulsification cataract extraction and intraocular lens implantationis is good,this kind of surgery can reduce the steps,is more convenient and fast.and avoid the separation of water-related complications.