白内障微切口同轴超声乳化联合MI60型人工晶状体植入的临床疗效观察

Effect of coaxial phacoemulsification with micro corneal incision(1.8 mm) plus MI 60 IOL implantation in cararact patients

目的通过1.8 mm与3.0 mm同轴白内障超声乳化联合植入人工晶状体的术后裸眼视力、角膜散光,角膜内皮计数的统计分析,探讨白内障微切口(1.8 mm)同轴超声乳化的临床应用价值。方法将60例(60眼)按性别、年龄、视力、白内障的成熟程度配对,每对中随机抽取1例分入A组,另一例分入B两组。A组行透明角膜3.0 mm传统切口白内障同轴超声乳化联合博士伦普通折叠型人工晶体植入术,B组行透明角膜1.8 mm微切口白内障同轴超声乳化联合博士伦超薄型人工晶体即MI60型人工晶状体植入术。观察两组患者术前、术后1 d、1周、1个月、3个月的裸眼视力,角膜散光和角膜内皮细胞情况。结果术后1 d、1周、1个月、3个月时B组裸眼视力均优于A组,两者之间差异均有统计学意义(P<0.05)。术后1 d,A、B两组角膜散光与术前相比,差异均有统计学意义(P<0.05);但B组角膜散光均小于A组(P<0.05)。术后1周、1个月、3个月时,A组与术前相比,散光差异仍具有统计学意义(P<0.05),B组与术前相比,差异已没有统计学意义(P>0.05);且术后各阶段,B组角膜散光均小于A组(P<0.05)。在术后各阶段,A、B两组的角膜内皮计数均没有统计学差异。结论白内障同轴超声乳化透明角膜1.8 mm微切口与3.0 mm传统切口相比,尽管两者对角膜内皮细胞的损伤没有差异,但后者的术后裸眼视力恢复更快、更好,其手术源性角膜散光可以忽略不计。

Objective Based upon clinical observation and analysis of postoperative visual acuity, corneal astigmatism and corneal endothelial count, this study aims to explore the feasibility, safety and merits of coaxial phacoemulsificatoin with 1.8 mm with 3.0 mm in the patients with cataract. Methods 60 cases （60 eyes） were divided into two groups of A and B randomly according to gender, age, visual acuity and cataract maturity. The patients in group A underwent phacoemulsification joint ordinary folding intraocular lens（Bausch and Lamb） implantation with traditional 3.0 mm clear corneal incision. The patients in group B underwent coaxial phacoemulsificatoin joint miniature folding inlxaocular lens（MI 60, Bausch and Lamb） implantation with 1.8 nun clear corneal microincision. The visual acuity, corneal astigmatism and corneal endothelial count of those patients were observed at the 1 st day, 1 st week, 1 st month, and 3 months after the operation. Results The uncorrect visual acuity of group B was better than those of group A at the 1st day, 1st week, 1st month and 3 months after the operation（P〈0.05）. The corneal astigmatism of group B was less than those of group A at the 1 st day, 1st week, 1 st month, and 3 months after the operation（P（0.05）. Except for 1st day after the operation, there were no significant differences in corneal astigmatism of group B between pre-operation and post-operation （P^0.05）. Conversely, the differences in corneal astigmatism of group A between pre-operation and post-operation was obvious（P（0.05）. The difference in corneal endothelial count between the two groups manifested no ostensible statistical significance at each point after operation （P^0.05）. Conclusions There are no significant differences in the total time and effective time consuming in phacoemulsificatoin and the influence on corneal endothelialbetween group with 3.0 mm clear corneal incision and group with 1.8 mm clear corneal microincision. The better postoperative uncorrect visual acuity recovered, the better the corneal original form can be maintained. Besides, the surgery astigmatism could be ignored ino the group with 1.8ram coaxial microincision phacoemulsificatoin compared with the group with 3.0 mm traditional clear corneal incision.