巩膜电凝对小切口白内障囊外摘除术后角膜散光及切口愈合的影响

Scleral electric coagulation on postoperative astigmatism and incisional cicatrization after extracapsular cataract extirpation with small incision

目的 研究巩膜电凝（SEC）对小切口白内障囊外摘除术（SIECCE）后角膜散光及切口愈合的影响.方法 选取2012年1月至2013年12月齐河县人民医院眼科行SIECCE并人工晶体植入术（IOLI）的白内障患者80例,随机分为观察组和对照组,每组40例,观察组采用SEC,对照组不采用.采用角膜地形图仪比较两组术后角膜散光的变化,通过裂隙灯观察术后眼前房反应.结果 手术后1周,观察组与对照组角膜散光分别为0.88±177;0.47、1.24±177;0.79,观察组角膜散光明显小于对照组（t=2.20,P＜0.05）,术后1个月两组角膜散光分别为0.86±177;0.54、1.01±177;0.69,差异无统计学意义（t=1.14,P＞0.05）;术后3个月两组角膜散光分别为0.79±177;0.28、0.87±177;0.49,差异无统计学意义（t=1.86,P＞0.05）;对照组术后发生浅前房、前房渗漏者分别有2例（5.00％）、3例（7.50％）,并发症发生率为12.50％,观察组无一例发生此类术后并发症,并发症发生率为0,观察组明显低于对照组（x2=13.83,P＜0.01）.结论 SIECCE采用SEC不仅可以增强切口稳定性,减少术后早期角膜散光,并且可以促进切口愈合,避免手术后浅前房、前房渗漏等术后并发症的发生.

Objective To study the effects of scleral electric coagulation（SEC） on postoperative astigmatism and incisional cicatrization after extracapsular cataract extirpation with small incision （SIECCE）.Methods From January 2012 to December 2013,70 cataract patients in Qihe County People′s Hospital,were randomly divided into observation group and control group,with 40 cases in each group.Observation group used the SEC,the control group did not use.Using corneal topographic map meter compared postoperative corneal astigmatism of two groups,postoperative anterior chamber reaction was observed through the slit lamp.Results One week after the surgery,corneal astigmatism of observation group and control group respectively was 0.88 ±177; 0.47,1.24 ±177; 0.79,that of observation group was smaller than that of the control group （P 〈 0.05） ; postoperative 1,3 months,the corneal astigmatism of observation group and control group respectively was 0.86 ±177;0.54,1.01 ±177;0.69;0.79 ±177;0.28,0.87 ±177; 0.49,there was no significant difference between the two groups[（t =1.14,P 〉 0.05）,（t =1.86,P 〉 0.05）] ; ostoperative shallow anterior chamber,leakage of anterior chamber of control group occurred respectively [2 cases（5.00%）,3 cases（7.50%）],the incidence of complications was 12.50%,no such postoperative complications occurred in observation group,the incidence of complications was 0,observation group was obviously lower than control group（x2 =13.83,P 〈0.01）.Conclusions SIECCE by the SEC,which not only can strengthen stability of incision,reduce early postoperative corneal astigmatism,and can promote healing of incision,prevent postoperative complications such as shallow anterior chamber and anterior chamber leaks.