改良手法小切口白内障手术在尼日尔的临床疗效

Efficacy of improved small incision cataract surgery in Niger

目的:评价改良手法小切口白内障手术在尼日尔的临床疗效。方法:选取2014年10月至2016年10月在受援尼日尔津德尔国家医院和尼日尔马拉迪中心医院的成熟期白内障患者800例(919眼),随机分为对照组(457眼)和治疗组(462眼),治疗组采用改良小切口白内障手术;对照组采用传统以上穹隆为基底的结膜瓣的手术方式。分别记录两组一般情况、手术时间、散光度及手术相关并发症。于术前、术后1 d、术后3 d、术后1周、术后2周及术后1个月分别记录两组的裸眼视力情况及角膜散光度。结果:两组年龄、性别比例、核硬度分级及术前角膜散光比较差异无统计学意义(P>0.05),两组患者术前裸眼视力比较差异无统计学意义(P>0.05)。与术前相比,两组术后裸眼视力治疗后均提高,散光度均有所降低(P<0.05);治疗组术后1,3 d时裸眼视力高于对照组(P<0.05),且治疗组术后角膜散光度及手术相关并发症发生率更低(P<0.05)。结论:改良手法小切口白内障手术,术后视力恢复早、手术安全性高、经济高效,是适合推广的术式。

Objective： To evaluate the efficacy of improved small incision cataract surgery in Niger. Methods： From October 1, 2014 to October 1, 2016, 800 cases（919 eyes） in the National Hospital of Niger Zinder were randomly divided into the experimental group（462 eyes） and the control group（457 eyes）. The patients in the experimental group underwent the improved small incision cataract surgery. In the control group, those received conventional surgery with the dome-based conjunctival flap. The baseline data operation time and postoperative complications were recorded. The uncorrected visual acuity and corneal astigmatism value at postoperative 1 day, 3 days, 1 week, 2 weeks and 1 month were statistically compared between two groups. Results： There was no significant difference in age, sex ratio, corneal astigmatism value and nuclear hardness between two groups（all P〉0.05）. There was no significant difference in uncorrected visual acuity between the groups before operation（P〉0.05）. Compared with the preoperative value, the uncorrected visual acuity was significantly improved and the corneal astigmatism was considerably decreased after surgery（P〈0.05）. The uncorrected visual acuity in the experimental group was significantly higher than that in the control group at 1 and 3 days after the operation（P〈0.05）. In the experimental group, the corneal astigmatism value and the incidence of postoperative complications were significantly lower than those in the control group（both P〈0.05）. Conclusion： The improved small incision cataract surgery can accelerate the recovery of visual acuity, improve the clinical efficacy and ensure surgical safety.