手法劈核人工晶状体植入辅助治疗高度近视并发白内障的应用价值研究

The value research of manual nucleus and IOL implantation for the treatment of high myopia complicated cataract

目的探讨小切口手法劈核联合人工晶状体植入治疗高度近视并发白内障的临床效果。方法选择咸阳市中心医院2013年6月至2014年6月收治的高度近视并发白内障患者共108例(114眼)作为研究对象,并按随机数字表法分为2组,观察组55例(58眼)和对照组53例(56眼)。其中,观察组患者采用小切口手法劈核联合人工晶状体植入术进行治疗,而对照组则采用常规超声乳化联合人工晶状体植入术进行治疗。观察并比较2种手术前后患者裸眼视力、最佳矫正视力以及术后并发症发生率等指标的差异。结果 2组患者术前的裸眼视力、最佳矫正视力差异均无统计学意义(P>0.05),但术后均明显改善,观察组术后裸眼视力为(0.69±0.17),显著高于对照组的(0.42±0.13);并且,观察组术后最佳矫正视力≥0.3者51眼(88%),最佳矫正视力≥0.5者39眼(67%),显著高于对照组的43眼(77%)和28眼(50%);观察组术后并发症发生率仅为9%(5/58),明显低于对照组的23%(13/56),2组间差异具有统计学意义(P<0.05)。结论小切口手法劈核联合人工晶状体植入治疗高度近视并发白内障的疗效显著,安全性高,值得在临床上推广使用。

Objective Explore the clinical results of manual nucleus and IOL implantation for the treatment of high myopia complicated cataract.Methods Selected 108 cases patients（114eyes）with high myopia complicated cataract in our hospital from June 2013 to June 2014 as the research subjects.And randomly divided into two groups with 55cases（58eyes）of the observation group and 53cases（56eyes）of the control group press on the number table method.Among them,the observation group were treated with manual nucleus and IOL implantation;while the control group were treated with conventional phacoemulsification and IOL implantation.Observed and compared to difference of the indicators such as uncorrected visual acuity,best corrected visual acuity and incidence of postoperative complications before and after surgery.Results There were no significant difference of patients for preoperative visual acuity and best corrected visual acuity（P〈0.05）.But they were significantly improved after surgery.The postoperative uncorrected visual acuity of the observation group was（0.69±0.17）,significantly higher than the（0.42±0.13）of the control group.Also,the observation group with the best corrected visual acuity for≥0.3had 51eyes（88%）.And for≥0.5had 39eyes（67%）,significantly higher than the 43eyes（77%）and 28eyes（50%）of the control group.In addition,the postoperative complication rate of the observation group was 9%（5/58）,significantly lower than the 23%（13/56）in the control group which difference was statistically significant（P〈0.05）.Conclusion The manual nucleus and IOL implantation use for the treatment of high myopia complicated cataract is significant effect and safe which should be introduced in clinical practice.