同轴1.8mm微切口白内障超声乳化吸除术治疗硬核白内障的临床疗效观察

Clinical outcomes of 1.8mm coaxial micro incision phacoemulsification in the treatment for hard nucleus cataract

目的观察同轴1.8 mm微切口白内障超声乳化吸除术治疗硬核白内障的临床疗效。方法选择符合硬核白内障患者为研究对象100例,根据本院临床研究中心经过双盲法随机分组为研究组和观察组。研究组使用同轴1.8 mm微切口白内障超声乳化吸除术联合折叠式晶状体植入术,观察组使用3.0 mm同轴小切口白内障超声乳化吸除联合折叠式晶状体植入术。术后观察患者视力、散光等恢复情况。结果比较两组患者术后视力矫正情况,研究组患者人数明显高于观察组,两组患者比较有统计学意义(P<0.05),在角膜地形图散光比较中,两组比较有统计学意义。微切口在患者散光的矫正率中随时间变化增长。检测两组患者角膜内皮细胞数目。术后7d,研究组角膜内皮细胞单位密度高于观察组,有统计学差异,30 d、90 d两组比较无统计学差异。对于角膜内皮细胞增长长期随访中,微切口与小切口无明显差异。通过检测两组患者术前以及术后7 d、30 d、90 d眼内压以及中央前房深度变化测定并比较两组患者在术后出现的并发症情况,统计学显示无意义。结论同轴1.8 mm微切口白内障超声乳化吸除术治疗硬核白内障有临床应用价值,能提高临床治愈率,值得临床应用推广。

Objective To evaluate the efficacy of 1.8mm ultrasonic emulsification combined with intraocular lens implantation in the treatment for hard nuclear cataract. Methods 100 patients with hard nuclear cataract were enrolled in this study. Patients were given either coaxial 1.8 mm micro incision or 3.0 mm coaxial small incision phacoemulsification combined with a folding lens implantation. Postoperative visual acuity, astigmatism and other outcomes were observed. Re- stilts Postoperative visual acuity was significantly better in patients received 1.8 mm micro incision than in patients re- ceived 3.0 mm small incision （ P 〈 0.05 ）. Astigmatism assessed by corneal topography was also significantly smaller. 7 day after surgery, endothelial cell density was significantly higher in patients received 1.8 mm micro incision. But this difference disappeared at 30 days and 90 days. There was no difference in intraocular pressure between the two groups. Conclusions 1.8 mm coaxial micro incision phacoemulsification is a safe and effective treatment for hard nuclear cata- ract. This surgical method improves the clinical cure rate and is worthy of clinical application and promotion.