小切口非超声乳化囊袋内手法劈核术在硬核性白内障中的应用

Application of small-incision non-phacoemulsification intracapsular nucleus chopping technique for hard nucleus cataract

目的探讨囊袋内手法劈核术在硬核性白内障手术中的临床效果。方法采用小切口非超声乳化囊袋内的手法劈核术,治疗硬核性白内障117例(159眼),分别于术后1周、1个月、3个月、6个月观察患者术后视力、散光、角膜内皮细胞丢失率、并发症等情况。结果术后1周最佳矫正视力≥0.5者占54.1%,术后散光度数为(2.00±0.75)D,角膜内皮细胞密度为(3327±231)mm-2,角膜内皮细胞丢失率为3.00%;术后1个月最佳矫正视力≥0.5者占86.2%,术后散光度数为(1.50±0.75)D,角膜内皮细胞密度为(3271±253)mm-2,角膜内皮细胞丢失率为4.64%;术后3个月最佳矫正视力≥0.5者占91.2%,术后散光度数为(1.25±0.50)D,角膜内皮细胞密度为(3267±239)mm-2,角膜内皮细胞丢失率为4.75%;术后6个月最佳矫正视力≥0.5者占92.5%,术后散光度数为(1.00±0.50)D,角膜内皮细胞密度为(3257±242)mm-2,角膜内皮细胞丢失率为5.04%,无严重并发症发生。术后视力,散光度差异均有统计学意义(均为P<0.05),角膜内皮细胞丢失率差异均无统计学意义(均为P>0.05)。结论对Ⅳ-Ⅴ级硬核性白内障应用囊袋内手法劈核术,不仅具有小切口的优点,而且角膜相关并发症少,操作更安全,术后视力恢复快。

Objective To evaluate the clinical efficacy of intracapsular nucleus chopping technique for hard nucleus cataract.Methods One hundred and seventeen patients（159 eyes）with hard nucleus cataract were treated by small-incision non-phacoemulsification intracapsular nucleus chopping technique,the postoperative visual acuity,astigmatism,corneal epithelial cell losing rate and complications were observed at 1 week,1 month,3 months and 6 months after operation.Results The postoperative best corrected visual acuity ≥0.5 at 1 week,1 month,3 months and 6 months were in 54.1%,86.2%,91.2% and 92.5%,respectively.The postoperative astigmatism at 1 week,1 month,3 months and 6 months were（2.00±0.75）D,（1.50±0.75）D,（1.25±0.50）D and（1.00±0.50）D,respectively.The postoperative density of corneal epithelial cells at 1 week,1 month,3 months and 6 months were（3 327±231）mm-2,（3 271±253）mm-2,（3 267±239）mm-2 and（3 257±242）mm-2,respectively.The postoperative corneal endothelial cell losing rates at 1 week,1 month,3 months and 6 months were 3.00%,4.64%,4.75% and 5.04%,respectively.There were statistical differences in postoperative best corrected visual acuity and astigmatism among different time points（all P0.05）,but no difference in corneal endothelial cell losing rate（all P0.05）.No serious complications occurred.Conclusions Application of intracapsular nucleus chopping technique for Ⅳ-Ⅴ hard nucleus cataract,not only has the advantages of small incision,but also the less corneal complications,safer operation and faster visual recovery after surgery.