白内障患者超声乳化术中瞳孔直径变化的临床分析

Clinical analysis on the pupil diameter changes of cataract patients during phacoemulsification

目的：研究白内障患者超声乳化术中瞳孔直径的变化,了解其对白内障超声乳化术影响。方法：区组设计,前瞻性研究。选取60例60眼白内障手术患者,根据年龄分为两组,年轻组（A组）20例20眼和老年组（B组）40例40眼。术前均采用复方托吡卡胺滴眼液充分散瞳,术中计算机软件处理图像,并且根据角膜的放大比例测量以下手术时相的瞳孔直径：作角膜隧道切口前（t1）、注入黏弹剂后（t2）、人工晶状体植入前（t3）、手术结束即刻（t4）。采用SPSS 18.0统计软件分析数据。结果：患者t1~t4的瞳孔直径测量值±次为：A组8.36±0.65,8.97±0.50,8.67±0.63,8.72±0.96mm;B组7.73±0.58,8.23±0.59,7.89±0.16,7.70±0.63mm。两组间总体的比较：在手术的不同时相,瞳孔直径测量值存在组间差别（F=26.696,P〈0.05）;两组中,在不同时间点的比较：t1~t4时相的瞳孔直径,A组均大于B组,差异有统计学意义（P〈0.05）。各组患者的瞳孔直径测量值在手术的不同时相有变化的趋势（F=23.423,P〈0.05）,且两组变化趋势比较无显著性差异（F=2.617,P〉0.05）;同一组中,不同时间点的比较：各组内t2时相的瞳孔直径测量值均大于t1时相测量值,差异有统计学意义（P〈0.05）;各组内术中t2~t4时相瞳孔直径测量值两两比较,A组差异均无统计学意义（P〉0.05）,B组t3和t4时相瞳孔直径减小,差异均有统计学意义（P〈0.05）。结论：复方托吡卡胺滴眼液术前散瞳下,年轻白内障患者和老年白内障患者均可达到手术所需散瞳效果,老年白内障患者超声乳化术中瞳孔稳定性低于年轻白内障患者。

To study the changes of pupil diameter and its effects during phacoemulsification. METHODS： Block design, prospective study. 60 cataract patients （60 eyes） were selected, which divided into two groups according to the age, young age group （group A, 20 eyes of 20 patients） and older age group （group B, 40 eyes of 40 patients）. Two groups were all given compound tropicamide eye drops for fully mydriasis before operation, computer software to process images during operation, and according to the cornea amplification ratio measure pupil diameter during the operation phase： before the corneal tunnel incision （ t1 ） , after injection of sodium hyalurantae （ t2 ） , before artificial lens implantation （t3）, at the end of the surgery （ t4 ）. Statistical analysis of data using SPSS18. 0 software.RESULTS： The pupil diameter measurements of t1-t4 were followed respectively：group A were 8. 36 ± 0. 65, 8. 97±0. 50, 8. 67±0. 63, 8. 72±0. 96mm; group B were 7. 73± 0. 58, 8. 23 ± 0. 59, 7. 89 ± 0. 16, 7. 70 ± 0. 63mm. Overall comparisons between the two groups, the pupil diameter measurements had differences during the operation phase （ F = 26. 696, P〈0. 05 ）. Comparisons between the two groups at different time points： the pupil diameter of t1-t4 in group A was larger than that in group B, with statistically differences （P〈0. 05）. The pupil diameter of each groups had a tendency to change in different operation phrases, with no statistically differences （F=2. 617,P〉0. 05）. Comparisons in a group at different time points： the pupil diameter of t2 was larger than that in t1, with statistically differences （ P〉0. 05）, the pupil diameter of t3 and t4 were decreased in group B, with statistically differences （P〈0. 05）.CONCLUSlON： Compound tropicamide eye drops are given for mydriasis before operation, young patients with cataract and senile patients with cataract can achieve the effect of surgery for mydriasis, the pupil stability of phacoemulsification in senile patients with cataract are lower than that in young patients with cataract.