同等硬核白内障两种不同术式效果比较

Comparision of two different surgical procedures for hard nuclear cataract

目的比较同等硬核（Ⅲ级-Ⅴ级）白内障小切口非超声乳化摘出与超声乳化吸出两种不同术式的临床效果。方法对386例（404眼）Ⅲ级以上硬核的老年性白内障随机分为2组，分别进行小切口非超声乳化术摘出194例（206眼）和超声乳化术吸出192例（198眼），均一期植入硬质人工晶状体，对术后视力、角膜散光度及并发症进行对比观察。结果Ⅲ级硬核白内障，术后视力、角膜散光度、后囊破裂发生率和角膜水肿发生率，两组间差异无统计学意义（P〉0．05）；Ⅳ、Ⅴ级硬核白内障，术后角膜水肿发生率，小切口非超声乳化组明显低于超声乳化组，两组间差异有统计学意义（P〈0．05）。结论白内障小切口非超声乳化术具备超声乳化的优点，并能减少角膜内皮损伤，而且手术简便、安全、快捷，是基层医院治疗硬核白内障的较好选择。

Objective To compare the clinical efficacy of manual small-incision cataract surgery with phacoemusification in the management of hard nuclear cataract. Methods 404 eyes of 386 senile cata- ract with hard nuclei grade over HI were randomly divided into two groups： small-incision cataract surgery group （206 eyes of 194 cases） and phacoemusification group （198 eyes of 192 cases）. Primary intraocular lenses implantation were performed in all cases. The postoperaive visual acuities, corneal astigmatism and surgical complications were compared between two groups. Results For cataract patients with grade Ⅲ hard nuclei, there were no significant differences in postoperative visual acuities, corneal astigmatism, pos- terior capsule rupture and corneal edema beween two groups. For cataract paients with grade Ⅳ or Ⅴ hard nuclei, the incidence of corneal edema was much lower in manual small-incision cataract surgery group than phacoemusification group, and the difference was statistically significant. Conclusion Small-incision cata- ract surgery is safe, time-saving and easy to operate which is the ideal choice for hard nuclear cataract pa- tients in rural hospital.