劈核技术辅助的改良小切口白内障囊外摘除术在防盲手术中的应用

Application of chopping technique aided modified small incision extracapsular cataract extraction in blindness prevention

目的评价表面麻醉下劈核技术辅助的改良小切口白内障囊外摘除术在大规模防盲手术中的应用效果。方法四川省贫困白内障手术患者随机分为常规组403例(403只眼)和改良组459例(459只眼),分别在表面麻醉下行常规小切口白内障囊外摘除术联合人工晶状体植入术和劈核技术辅助的改良小切口白内障囊外摘除术联合人工晶状体植入术。观察术前、术后1 d最佳矫正视力,脱盲率和并发症。结果术后1 d常规组最佳矫正视力为0.482,改良组最佳矫正视力为0.579,两组间差异有统计学意义(P<0.05)。常规组403例中脱盲387例、脱盲率为96.03%;改良组459例中脱盲445例,脱盲率为96.95%。两组间差异无统计学意义(P>0.05)。两组均无眼内炎等严重并发症。结论劈核技术辅助的改良小切口白内障囊外摘除术值得在大规模防盲手术中推广应用。

Objective To evaluate the role of chopping technique aided modified small incision extracapsular cata- ract extraction （ECCE） under topical anesthesia in blindness prevention. Methods Impoverished cataract patients in Si- chuan were randomly divided into two groups. Control group （403 patients, 403 eyes） underwent regular small incision ECCE and intmocular lens implantation under topical anesthesia, and treatment group （459 patients, 459 eyes） underwent chopping technique aided modified small incision ECCE and intraecular lens implantation under topical anesthesia. The best corrected visual acuity （BCVA） were observed before surgery and at I day after operation. The recovery rate of blind- ness and the ecular complications were also observed after surgery. Resttlts The average BCVA at 1 day after operation was 0. 482 in control group and 0. 579 in treatment group. There was statistically significant difference between the two groups （ P 〈0. 05）. The recovery rate of blindness was 96.03% in control group while it was 96.95% in treatment group. There was no difference between two groups （ P 〉 0. 05 ）. There were no severe complications, such as endcoph- thalmotis, in either group of patients. Conclusion The chopping technique aided modified small incision extracapsular cataract extraction is worth to apply in the large population for blindness prevention.