不同年龄白内障患者超声乳化术中瞳孔直径的变化对手术时间及疗效的影响

Effect of Pupil Diameter Changes on the Surgical Procedure and Therapeutic Effect of Phacoemulsification in the Treatment of Cataract Patients with Different Age

目的：探讨不同年龄白内障患者超声乳化术中瞳孔直径的变化对手术时间及疗效的影响。方法：选取行超声乳化术治疗的白内障患者76例,根据患者实际年龄分为中青年组（n=32）与老年组（n=44）,所有患者术前常规复方托吡卡胺滴眼液散瞳,术中应用计算机图像处理软件依据角膜放大比例计算患者瞳孔直径,分别记录术中角膜隧道切口前（T1）、注入黏弹剂后（T2）、人工晶状体植入前（T3）、手术结束即刻（T4）4个时间点瞳孔直径,比较两组白内障患者平均手术时间、各时间点瞳孔直径及治疗有效果。结果：中青年组患者T1~T4各时间点瞳孔直径分别为（8.35±0.57）mm、（8.98±0.52）mm、（8.68±0.61）mm、（8.74±0.69）mm,老年组瞳孔直径分别为（7.72±0.46）mm、（8.25±0.66）mm、（7.79±0.21）mm、（7.69±0.67）mm,两组患者各时间点瞳孔直径比较差异有统计学意义（P〈0.05）;中青年组手术时间（67.5±12.4）min,老年组（77.8±15.3）min,差异有统计学意义（P〈0.05）;中青年组治疗后总有效率为93.75%,老年组总有效率为90.91%,两组比较差异无统计学意义（P〉0.05）。结论：复方托吡卡胺用于超声乳化术治疗白内障散瞳效果显著,尤其对于中青年白内障患者具有手术用时短的优点。

Objective： To investigate the effect of pupil diameter changes on the surgical procedure and surgical effect of phacoemulsification. Methods： Seventy-six patients with cataract treated by phacoemulsification were divided into middle age and youth group（ n = 32） and the elderly group（ n = 44）according to the age of patients. All patients underwent conventional compound tropicamide eye drops for mydriasis. Computer image processing software was used to calculate the diameter of the pupil. Pupil diameter was recorded before corneal tunnel incision（ T1）,after injecting viscoelastics（ T2）,before intraocular lens（ IOL） implantation（ T3）,immediately after operation（ T4）. Mean operation time,pupil diameter during each period and treatment efficiency were compared between the two groups. Results： Pupil diameter at T1 ~ T4 were（ 8. 35 ± 0. 57） mm,（ 8. 98 ± 0. 52） mm,（ 8. 68 ±0. 61） mm,（ 8. 74 ± 0. 69） mm respectively in middle age and youth group and were（ 7. 72 ± 0. 46）mm,（ 8. 25 ± 0. 66） mm,（ 7. 79 ± 0. 21） mm,（ 7. 69 ± 0. 67） mm respectively in elderly group,the difference between the two groups was statistically significant（ P〈0. 05）. Operation time in middle age and youth group,elderly group was（ 67. 5 ± 12. 4） min and（ 77. 8 ± 15. 3） min respectively,the difference was statistically significant（ P〈0. 05）. Treatment efficiency in middle age and youth group,elderly group was 93. 75% and 90. 91% respectively,the difference was statistically significant（ P〈0. 05）. Conclusion： The curative effect of compound tropicamide eye drops for mydriasis during phacoemulsification is good,especially for middle age and young people with cataract having the advantages of short operation time