黏弹剂冲洗针在小切口白内障手术中的应用分析

Application Analysis of Ophthalmic Viscoelastic Agent and Blunt Syringe Needle in Improved Small Incision Cataract Surgery

目的:评价黏弹剂冲洗针在小切口白内障手术中的应用效果。方法:对2011年4月至2013年5月"复明工程"中213例(213眼)白内障患者行改良小切口白内障摘除人工晶状体植入术,按皮质处理方式的不同将患者随机分为传统小切口组和黏弹剂冲洗针组。比较两组患者术后视力、角膜内皮细胞损失率、手术时间、术后并发症等。结果:所有患者均一期人工晶状体植入。黏弹剂冲洗针组手术时间、角膜内皮细胞损失率、术后并发症发生率分别为(7.6±4.2)min、(8.76±3.29)%、25.23%,传统小切口组分别为(8.8±3.4)min、(9.66±3.32)%、31.13%。两组手术时间和角膜内皮细胞损失率比较,差异均有统计学意义(P<0.05)。两组患者术后3 d及术后1月视力及术后并发症比较差异均无统计学意义。结论:改良小切口白内障摘除人工晶状体植入术,采用黏弹剂冲洗针代替传统的注吸器效果较好,是一种安全、有效、快速的手术方式,适用于白内障复明工程,尤其是硬核患者。

Objective To evaluate the efficacy of ophthalmic viscoelastic agent and blunt syringe needle in the improved small incision cataract surgery. Methods A total of 213 patients with cataract including 213 eyes in the ＂preventing blinding project＂ received improved small incision cataract surgery and intraocular lens implantation from April 2011 and May 2013. The patients were randomly divided into traditional small incision group, and ophthalmic viscoelastic agent and blunt syringe needle group according to the lens cortex treated method. The postoperative vision, lost counts of corneal endothelial cells, operative time and complications were compared between two groups. Results All patients received the implantion of in- traocular lens in phase I surgery. The average operative time, lost rate of corneal endothelial cells, and incidence rate of postoperative complications were （7.6 ± 4.2） min, （8.76 ± 3.29 ）%, and 25.23% in ophthalmic viscoelastic agent and blunt syringe needle group, respectively, meanwhile, the above indexes were （ 8.8 ± 3.4 ） min, （ 9.66 ± 3.32 ） %, and 31.13% in traditional small incision group. The lost rates of corneal endothelial ceils had significant difference between two groups（P 〈 0.05 ）, but the postoperative vision and complications had no difference. Gonclusion Compared with the tradi- tional infusion-aspiration syringes, the improved small incision cataract surgery and intraocular lens implantation by using ophthalmic viscoelastic agent and blunt syringe needle is more safe, effective, quick, and practical for patients with cataract that enrolled in ＂preventing blinding project＂ ,especially for the patients with hardcore.