高龄白内障患者同轴1.8mm微切口超声乳化术后黄斑区视网膜厚度的临床观察

Observation of macular thickness in highly senile cataract patient after 1.8 mm coaxial micro-incision phacoemulsification

目的探讨同轴1.8 mm微切口白内障超声乳化吸除人工晶状体植入术对高龄白内障患者黄斑区平均视网膜厚度的影响。方法前瞻性随机对照研究。选择80岁以上高龄老年性白内障患者46例(46只眼),随机分为2组,A组患者23例(23只眼)行1.8 mm白内障超声乳化吸除联合Akreos MI60人工晶状体植入术,B组23例(23只眼)行3.0 mm白内障超声乳化吸除联合Tecnis ZA9003人工晶状体植入术。分别于术前、术后1个月及术后3个月以观察黄斑区平均视网膜厚度的变化。采用SPSS 15.0统计学软件进行数据分析。结果所有患者术后术眼最佳矫正视力均较术前提高,OCT检查结果提示术后1个月A组黄斑区平均视网膜厚度(269.71±32.35)μm,B组黄斑区平均视网膜厚度(278.89±37.39)μm,两组比较差异有统计学意义(P<0.05);术后3个月A组黄斑区平均视网膜厚度(257.86±27.42)μm,B组黄斑区平均视网膜厚度(261.18±25.17)μm,两组比较差异有统计学意义(P<0.05)。结论与传统3.0 mm小切口手术相比,1.8 mm微切口白内障超声乳化吸除术治疗高龄白内障可显著减轻手术对黄斑区视网膜的影响,从而保持稳定的视觉质量。

Objective To clarify the effects of 1.8 mm coaxial micro-incision phacoemulsification on macular thickness in highly senile cataract patients.Methods This is a prospective randomized controlled study.Forty-six highly senile cataract patients（46 eyes） were divided into two groups randomly.Group A： twenty-three highly senile cataract patients（23 eyes） received 1.8 mm coaxial micro-incision phacoemulsification and Akreos MI60 IOL implantation.Group B：twenty-three highly senile cataract patients（23 eyes） received 3.0 mm coaxial micro-incision phacoemulsification and Tecnis ZA9003 IOL implantation.Macular thickness was measured by OCT before and after surgery at 1 month and 3 months.Statistical analysis was performed with the SPSS for windows（V 15.0,SPSS）.Results Best corrected visual acuity improved in all patients.There was statistically significant difference in macular thickness between group A and B at 1 month（P 〈 0.05） and 3 months（P 〈 0.05）.Conclusion Compared with 3.0 mm small incision surgery,1.8 mm coaxial micro-incision phacoemulsification can reduce the impact on macular thickness and consistent visual quality improvement.