超声乳化与晶状体植入对高度近视并白内障患者中央角膜厚度及OCT的影响

Effect of Phacoemulsification and Lens Implantation on Central Corneal Thickness and OCT in Patients with High Myopia and Cataract

目的:探讨超声乳化吸出并人工晶状体植入手术治疗高度近视合并白内障对视觉质量、中央角膜厚度及黄斑光学相干断层扫描(OCT)的影响。方法:选择我院2014年3月至2016年3月收治的112例高度近视合并白内障患者,参照抽签法分为对照组与研究组,每组56例。对照组采用白内障囊外摘除并人工晶状体植入术治疗,研究组采用超声乳化吸出并人工晶状体植入手术治疗。比较两组临床疗效,手术前后散光度、最佳矫正视力、中央角膜厚度、黄斑中心凹视网膜厚度的变化及术后并发症的发生情况。结果:研究组总有效率高于对照组(94.64%vs 78.57%,P<0.05)。手术前,两组散光度、最佳矫正视力、中央角膜厚度、黄斑中心凹视网膜厚度比较差异无统计学意义(P>0.05);手术后,两组散光度均较手术前明显降低,且研究组低于对照组(P<0.05),两组最近矫正视力均较手术前显著上升,且研究组高于对照组(P<0.05),对照组中央角膜厚度、黄斑中心凹视网膜厚度较手术前显著增加,研究组手术前后中央角膜厚度、黄斑中心凹视网膜厚度比较差异无统计学意义(P>0.05)。研究组并发症如角膜水肿、囊膜浑浊、房水浑浊、高眼压的发生率显著低于对照组(P<0.05)。结论:超声乳化吸出并人工晶状体植入手术治疗高度近视合并白内障的临床效果确切,可提高视觉质量,缓解对中央角膜厚度及黄斑OCT的影响。

Objective： To research the influence of ultrasonic emulsification sucked out and intraocular lens implantation on the visual quality,central corneal thickness and macular optical coherence tomography（ OCT） of high myopia patients combined with cataract. Methods： 112 cases of high myopia patients with cataract from March 2014 to March 2016 were selected and divided into the control group and the research group according to the lottery method,with 56 cases in each group. The control group was treated with extracapsular cataract extraction and intraocular lens implantation,the study group was treated with phacoemulsification and intraocular lens implantation. The clinical curative effect,changes of the luminosity,best corrected visual acuity,central corneal thickness,concave retinal thickness macular center before and after surgery,and postoperative complications were compared between two groups. Results： The total effective rate of research group was higher than that of the control group 94.64% vs 78.57%（ P〈0.05）. Before the operation,the luminosity,best corrected visual acuity,central corneal thickness,macular center concave retinal thickness showed no significant difference between two groups（ P〉0.05）. After surgery,the scattered luminosity of both groups were significantly lower than those before the surgery,which was lower in the research group than that of the control group（ P〈0. 05）; the best corrected visual acuity of both groups were rised than those before the surgery,which was higher in the research group than that of the control group（ P〈0.05）. The central corneal thickness and macular center concave retinal thickness of control group were increased than those before surgery. The central corneal thickness and concave retinal thickness macular center of research group showed no difference statistical significance between two groups（ P〉0.05）. The corneal edema,capsule membrane turbidity,aqueous humor turbidity and the incidence of high intraocular pressure of Complications in research group were significantly lower than those of the control group（ P〈0.05）. Conclusion： Phacoemulsification and intraocular lens implantation are effective in the treatment of high myopia with cataract,which can improve the visual quality and alleviate the effect of the central corneal thickness and macular OCT.