1.8mm同轴微切口白内障超声乳化术对角膜内皮及视力的影响

Effects of 1.8mm coaxial micro incision phacoemulsification on corneal endothelial injury and postoperative visual acuity

目的:探讨1.8mm同轴微切口白内障超声乳化术对角膜内皮损伤及术后视力恢复的影响。方法:选择2013-07/2015-07行白内障超声乳化吸除术患者120例145眼为研究对象,采用随机数字表法分为观察组60例73眼和对照组60例72眼,观察组采用1.8mm同轴微切口白内障超声乳化术,对照组采用传统3.2mm同轴切口白内障超声乳化术,比较两组患者术后裸眼视力(UCVA)、最佳矫正视力(BCVA)、切口部位角膜厚度、切口宽度、切口长度、黄斑中心凹视网膜厚度、手术源性散光、角膜内皮细胞计数、手术并发症等指标。结果:术后1wk,观察组UCVA、BCVA好于对照组,差异有统计学意义(t=3.604、7.109,P<0.05);术后1wk、1mo时,观察组切口宽度小于对照组,差异有统计学意义(t=205.3、225.2,P<0.05),切口长度大于对照组,差异有统计学意义(t=3.926、5.009,P<0.05);术后1wk,观察组黄斑中心凹视网膜厚度小于对照组,差异有统计学意义(t=2.817,P<0.05);观察组手术源性散光度小于对照组,差异有统计学意义(t=19.43、22.16,P<0.01);两组患者并发症(8.22%vs 11.11%)比较无统计学意义(χ~2=0.348,P>0.05)。结论:1.8mm微切口超声乳化技术有助于促进白内障患者视力恢复,可能与减轻角膜损伤、增强角膜闭合状态及降低术后术源性散光有关。

AIM：To investigate the effects of 1.8mm coaxial micro incision phacoemulsification on corneal endothelial injury and postoperative visual acuity.METHODS： Totally 145 eyes in 120 patients underwent phacoemulsification from July 2013 to July 2015 were randomly divided into observation group 60 cases （73 eyes） and control group 60 cases （72 eyes）.The observation group 60 cases were given 1.8mm coaxial micro incision cataract phacoemulsification operation,while the control group were given traditional 3.2mm coaxial micro incision cataract surgery.The uncorrected visual acuity （UCVA）,best corrected visual acuity （BCVA）,corneal thickness of incision area,incision width,incision length,macular retinal thickness,surgically induced astigmatism,corneal endothelial cell counts and complications of the two groups were compared.RESULTS： The UCVA and BCVA on 1wk after surgery of the observation group were significantly higher than the control group （t=3.604,7.109;P〈0.05）;the width of incision on 1wk and 1mo after surgery of the observation group were significantly less than the control group （t=205.3,225.2;P〈0.05）.The length of incision in observation group was significantly greater than the control group （t=3.926,5.009;P〈0.05）.Macular retinal thickness 1wk after surgery of the observation group was significantly less than the control group （t=2.817,P〈0.05）.The surgically induced astigmatism was significantly less than the control group （t=19.43,22.16;P〈0.01）;the difference of corneal edema between the two groups was not significant （8.22% vs 11.11%） （x2=0.348,P〉0.05）.CONCLUSION： The 1.8mm micro incision phacoemulsification is helpful to improve the visual acuity of patients with cataract phacoemulsification,which may be related to the reduction of corneal cell injury,enhancement of corneal closure and decrease post-operation corneal original astigmatism.