辅助器械保护下超声乳化治疗硬核白内障的临床观察

Clinical observation of auxiliary equipment for phacoemulsification in treatment of hard nucleus cataract

目的:比较辅助器械保护下超声乳化和传统超声乳化治疗硬核白内障的手术效果。方法:将87例115眼Ⅳ～Ⅴ级硬核白内障随机分成两组,A组44例58眼采用辅助器械保护下超声乳化,即用超声乳化头吸住碎核块后略为停顿,将辅助器械(Chop钩)挡在碎核块和角膜之间,位于碎核块正中上方,再乳化吸除核块。B组43例57眼为对照组,采用传统超声乳化方式吸除混浊的晶状体。分别比较两组术后1,3d;1mo时的视力、角膜水肿、角膜内皮细胞丢失率、术中超声乳化时间、术中术后并发症。结果:术后1,3d时,A组视力恢复较B组快(P<0.05);1mo时两组视力差异无统计学意义。3d;1mo时两组角膜内皮细胞丢失率差异有显著性(P<0.05)。术中术后并发症差异无显著性(P>0.05)。结论:辅助器械保护下超声乳化与传统超声乳化术相比,对内皮细胞损伤小,是一种有效、安全的超声乳化手术技巧。

· AIM ： To compare the effect of application of auxiliary equipment protection onphacoemulsification and conventional phacoemulsification in treatment of hard nucleus cataract. · METHODS： Totally 87 cases （115 eyes） Ⅳ -Ⅴ nuclear cataract were randomly divided into two groups. Forty-four cases （58 eyes） were in group A. In this group, auxiliary equipment （Chop hook） protection was used in ultrasonic emulsification. During the surgery, there was a slightly pause after the nuclear fragmentation was sucked by the phaco tip. Then the auxiliary equipment was placed between the nuclear fragmentation and the cornea, that was just located above the blocked nuclear, After that, the nuclear fragmentation was removed through phacoemulsification. Forty- three cases （57 eyes） were in Group B, which was treated with traditional phacoemulsification. Visual acuity, corneal edema, the loss rate of corneal endothelial cell, intraoperative ultrasound emulsification time, intraoperative and postoperative complications were compared between the two groups at 1 day, 3 days and 1 month after operation. · RESULTS： One and 3 days after operation, the rate of vision recovery in group A was faster than that in group B （ P 〈0.05）. One month later, there was no statistical difference between the two groups in vision. At 3 days and 1 month after operation, the corneal endothelial cell loss rate between the two groups was significantly different （P 〈0.05）. The complications of intraoperative and postoperative had no significant difference between the two groups （P 〉0.05）.