超声乳化白内障吸除术与中切口白内障囊外摘除术在复明工程疗效分析

Outcome of phacoemulsification and middle incision cataract extraction during Vision Action

目的:评价超声乳化白内障吸除术与中切口白内障囊外摘除术在云南省红河州复明工程中的疗效。方法:选择云南省红河州复明工程100例(100眼)年龄相关性白内障,随机分为两组,分别行超声乳化白内障吸除术和中切口白内障囊外摘除术,随访并比较两组术后3个月内裸眼视力、最佳矫正视力、眼压、角膜散光以及手术并发症。结果:超声乳化白内障吸除术组术后1周及1月裸眼及最佳矫正视力优于中切口白内障囊外摘除组,术后3个月两组视力无明显差异;两组术后各随访时间眼压无差异,且两组术后均较术前眼压降低约3 mmHg(P<0.01);超声乳化白内障吸除术后角膜散光的度数和性质均无明显改变(P>0.05),而中切口白内障囊外摘除术后1周及1月角膜循规性散光比例明显增加(P<0.001);两组手术患眼术中并发症及术后恢复过程相似。结论:在复明工程中,中切口白内障囊外摘除术安全有效,适于初学白内障手术的眼科医生操作。超声乳化白内障吸除术具有恢复快、近期效果好等特点,随经济发展及严格培训,也是可选择术式。

Objective： To evaluate the outcome of phacoemulsification and middle incision cataract extraction during Vision Action in Honghe,Yunnan Province.Methods： Total 100 cases of age-related cataract patients during Vision Action in Honghe,Yunnan Province were divided into two groups of this study,for whom phacoemulsification（Phaco） and middle incision cataract extraction（MICS） were performed.Uncorrected visual acuity,best corrected visual acuity,IOP,astigmatism,and complications were followed and compared for up-to 3 months postoperation.Results： At 1 week and 1 month postoperation,uncorrected visual acuity and best corrected visual acuity in phaco cases were better than those of MICS ones,and no difference was found at 3 months follow-up between these two groups.No significant difference was found between Phaco and MICS cases for IOPs during the follow-up;while postoperative IOPs in two groups were 3 mmHg lower than those of preoperative IOPs（P0.01）.Corneal astigmatism was not affected by phaco,while MICS induced more cases of astigmatism with the rule at 1 week and 1 month postoperatively（P0.001）.And no significant difference was found for surgery-related complications between these two groups.Conclusion： During Vision Action,MICS is a safe and effective surgery for cataract victims,especially takes the advantage of less damage to endothelial cells for the beginners of cataract surgeries.Phaco could restore vision in much shorter rehabilitation term,with the development of economics;it could be a choice for experienced surgeons after systematic training.