小切口白内障囊外摘除术与超声乳化治疗老年性白内障的疗效对比

Efficacy comparison of small incision extracapsular cataract extraction surgery and phacoemulsification on cataract in elderly

目的：探讨老年性白内障采用小切口白内障囊外摘除术与超声乳化治疗的临床效果。方法选取荥阳市人民医院眼科2013年11月至2014年11月收治的老年性白内障患者100例，随机分为小切口白内障囊外摘除术组（A 组）与超声乳化治疗组（B 组），每组50例。比较两组治疗效果。结果 B 组术后3 d 视力恢复良好率优于 A 组（P〈0.05），但术后1个月、3个月组间比较差异未见统计学意义（P〉0.05），且随时间延长，两组视力恢复良好率均呈上升趋势（P〈0.05）。相较术前，两组术后3 d、1个月散光度均好转（P〈0.05），术后3个月与术前比较差异未见统计学意义（P〉0.05）。且组间对比，B 组术后3 d 散光度轻于 A 组（P〈0.05），但术后1、3个月组间比较差异未见统计学意义（P〉0.05）。A 组瞳孔轻度上移、晶状体后囊膜破裂、角膜水肿等并发症率为16%，B 组为10%，差异未见统计学意义（P〉0.05）。两组术前角膜内皮细胞交角形细胞比率、细胞密度术前比较差异未见统计学意义（P〉0.05），术后B 组两项指标下降幅度均低于 A 组（P〈0.05）。结论老年性白内障采用小切口囊外摘除术，相较超声乳化吸出术，有基本相近的远期疗效，且其手术费用低、操作简单、安全有效，在基层医院及白内障复明工程中应用优势更为明显。

Objective To investigate the clinical effects of small incision cataract extraction surgery and phacoemul-sification on cataract in elderly. Methods From November 2013 to November 2014,100 patients with senile cataract in Xingyang people’s hospital were selected,and they were randomly divided into small incision extracapsular cataract extraction surgery group（group A）and phacoemulsification treatment group（group B）,with 50 cases in each group. The clinical effects were compared. Results After 3 d,the visual recovery rate in group B was higher than that in group A（P〈0. 05）, but after 1 month,3 months,there was no significant difference between the two groups（P〉0. 05）,and with time,the visu-al recovery rate showed an upward trend in both groups（P〈 0. 05）. Compared with before surgery,postoperative 3 d, 1 month astigmatism were improved（P〈0. 05）,there was no significant difference between after 3 months and before opera-tion（P〉0. 05）. And comparison between groups,postoperative 3 d astigmatism in group B was lighter than that in group A （P〈0. 05）,but there was no significant difference between 1 month and 3 month postoperatively（P〉 0. 05）. The pupils mild move on,posterior capsular rupture,corneal edema and other complications in goup A was 16% ,and in group B was 10% ,there was no significant difference（P〉0. 05）. There was no significant difference in preoperative corneal endothelial cell cross angular cell ratio,cell density between the two groups（P〉0. 05）,the two indicators were lower after operation in group B than that in group A（P〈0. 05）. Conclusions Cataract with small incision extracapsular cataract extraction,com-pared with phacoemulsification surgery,there are basically similar long-term effect and it has advantages of low operation cost,simple,safe and effective application in basic hospital and cataract project more obviously.