同轴微切口超声乳化手术对白内障的治疗效果及术后影响

Treatment and postoperative effects of coaxial micro-incision phacoemuisification on patients with cataract

目的:分析同轴微切口超声乳化手术对白内障的治疗效果及术后影响,探讨其临床应用价值。方法:将300例300眼接受超声乳化手术治疗的白内障患者随机分为观察组和对照组,各150例150眼。观察组患者采用同轴微切口超声乳化手术治疗,对照组患者则采用传统同轴常规切口超声乳化手术治疗。对比分析两组的有效超声乳化时间(effective phaco time,EPT)、平均超声能量(average ultrasound energy,AVE)、术中前房稳定性、术后恢复时间,以及术前和术后1d,1wk,1、3mo时测得的裸眼视力(UCVA)、手术源性角膜散光度数及角膜内皮细胞丢失程度。结果:两组EPT、AVE及术中前房稳定性均无明显统计学差异(P>0.05)。术前两组UCVA、角膜散光度数及角膜内皮细胞计数均无显著统计学差异(P>0.05)。观察组患者术后恢复时间明显短于对照组,差异有统计学意义(P<0.05)。与对照组比,观察组患者术后1d,1wk,1mo时UCVA均明显较好,差异有统计学意义(P<0.05);术后1wk,1、3mo时,手术源性角膜散光度数均明显较低,差异有统计学意义(P<0.05);术后1d,1wk,1、3mo时,角膜内皮细胞丢失率均明显较低,差异有统计学意义(P<0.05)。两组术后各时间点比较,UCVA、手术源性散光度数及角膜内皮细胞丢失率均有显著统计学差异(P<0.05)。结论:同轴微切口超声乳化术治疗白内障,术后视力恢复快,角膜散光小,角膜内皮细胞丢失程度低,临床应用价值相对较高。

AIM：To analyze the clinical efficacy and postoperative impacts of coaxial micro-incision phacoemulsification on patients with cataract,and explore the application value of the surgical method.METHODS：Totally 300 patients（300 eyes） who received the coaxial micro-incision phacoemulsification were randomly divided into the observation group（150case） and the control group（150 case）.Patients in the observation group and control group were treated by coaxial micro-incision phacoemulsification and traditional coaxial phacoemulsification,respectively.The effective phaco time（EPT）,average ultrasound energy（AVE）,intraoperative anterior chamber stability and postoperative recovery time were compared between the two groups,as well as the uncorrected visual acuity（UCVA）,the surgically induced astigmatism（SIA） and the loss rate of corneal endothelial cells at 1d,1wk,1 and3 mo after surgery.RESULTS：No significant difference of EPT,AVE and the rate of patients with stable anterior chamber were found between the two groups（P0.05）,as well as the UCVA,SIA and the corneal endothelial cells in patients before surgery（P0.05）.The postoperative recovery time of patients in the observation group was obviously shorter than that in the control group（P0.05）.At 1d,1wk and 1mo of postoperative,the UCVA of patients in the observation group were better than those in the control group（P 0.05）.In 1wk,1 and 3mo of postoperative,the SIA of patients in the observation group were lower than those in the control group（P0.05）.And in all the time of postoperative,the loss rate of corneal endothelial cells of patients in the observation group were lower than those in the control group（P0.05）.Between the two groups,significant difference of the UCVA,SIA and the loss rate of corneal endothelial cells were found in the different time points after surgery（P0.05）.CONCLUSION：The coaxial micro-incision phacoemulsification had a high clinical value as it possesses the advantages of more rapid UCVA recovery,less influence on SIA and less loss of corneal endothelial cell.