超声乳化术与小切口囊外摘除术治疗白内障患者的疗效及对角膜内皮细胞及生存质量的影响

Efficacy of Phacoemulsification and Small Incision Extracapsular Cataract Extraction in the Treatment of Cataract and Their Effects on Corneal Endothelial Cells and Quality of Life

目的:探讨超声乳化术与小切口囊外摘除术治疗白内障患者的疗效及对角膜内皮细胞及生存质量的影响。方法:选取2015年3月到2017年6月在我院接受治疗的白内障患者203例,根据随机数字表法将患者分为对照组100例和观察组103例。对照组患者给予小切口囊外摘除术进行治疗,观察组给予超声乳化术进行治疗。于术前、术后1周、术后1个月、术后3个月对所有患者的视力进行检测。于术前、术后2周检测患者的眼角膜内皮细胞数量,并计算细胞密度和六角形细胞比率。于术前和术后1个月采用生活质量评定量表对患者的生活质量进行评测,记录患者术后出现的并发症。结果:术前、术后1个月、术后3个月,两组患者的视力比较差异无统计学意义(P>0.05),术后1周观察组患者的视力明显高于对照组(P<0.05);术后2周两组患者的细胞密度、六角形细胞比率均降低,对照组的细胞密度低于观察组(P<0.05)。术前、术后1个月两组患者的自理能力、活动能力、社交能力、心理情绪得分比较差异无统计学意义(P>0.05),术后1个月两组患者的自理能力、活动能力、社交能力、心理情绪得分均高于术前(P<0.05)。两组患者的并发症发生率比较差异无统计学意义(P>0.05)。结论:与小切口囊外摘除术相比,超声乳化术能在短期内更快的提升患者视力,且对患者的眼角膜内皮细胞损伤较小,但两种手术近期疗效和并发症情况基本一致,且对患者生活质量的影响无差异。

Objective： To investigate the efficacy of phacoemulsification and small incision extracapsular cataract extraction in the treatment of cataract and their effects on corneal endothelial cells and quality of life. Methods： 203 patients with cataract who were treated in our hospital from March 2015 to June 2017 were selected, according to the random number table method, the patients were divided into the control group with 103 cases and the observation group with 100 cases. The control group was treated with small incision extracapsular cataract extraction, and the observation group was treated with phacoemulsification. The visual acuity of all patients was measured before operation, 1 weeks after operation, 1 months after operation and 3 months after operation. The number of corneal endothelial cells was measured before and 2 weeks after operation, and the cell density and hexagonal cell ratio were calculated. The quality of life was evaluated before and 1 months after operation, and the complications were recorded. Results： There was no significant difference in visual acuity between the two groups before operation, 1 months after operation and 3 months after operation（P〈0.05）, the visual acuity of the observation group was significantly higher than that of the control group 1 week after the operation（P〈0.05）. At 2 weeks after operation,the cell density and hexagonal cell ratio of the two groups were decreased, and the cell density of the control group was lower than that of the observation group（P〈0.05）. There was no significant difference in scores of self-care ability, activity ability, social ability and psychological emotion between the two groups before and 1 months after operation（P〈0.05）, the scores of self-care ability, activity ability, social ability and psychological emotion in the two groups 1 months after operation were higher than those before operation（P〈0.05）. There was no significant difference in the incidence of complications between the two groups（P〈0.05）. Conclusion： Compared with small incision extracapsular cataract extraction, phacoemulsification can improve the vision of patients faster in the short term, and it has less damage to the corneal endothelial cells, however, the short-term effects and complications of the two operations are basically the same, and there is no difference in the quality of life of the patients.