不同长度透明角膜切口超声乳化吸除联合折叠式人工晶状体植入术治疗白内障的疗效观察

Therapeutic effect of phacoemulsification with different lengths of corneal incision combined with foldable intraocular lens implantation for the treatment of cataract

目的研究白内障不同长度透明角膜切口超声乳化吸除联合折叠式人工晶状体植入对白内障患者的治疗效果。方法选取94例海宁市人民医院眼科2013年4月~2015年8月期间收治的白内障患者作为研究对象,按床位单双号分成两组,各47例。A组患者采用2.2 mm透明角膜切口行白内障超声乳化吸除联合折叠式人工晶状体植入术进行治疗;B组患者手术步骤与A组相同,仅透明角膜切口为2.8 mm。观察两组患者超声乳化和手术时间。术后随访患者3个月,观察两组患者术前、术后1周、术后1个月以及术后3个月的视力及手术源性散光情况。并观察两组患者并发症发生情况。结果 A组Ⅳ级核患者超声乳化时间明显长于B组(P<0.05);其余所有患者超声时间和手术时间比较,差异均无统计学意义(P>0.05)。两组患者术前、术后1周、术后1个月以及术后3个月之间视力情况比较,差异均无统计学意义(P>0.05)。两组患者术后1周、术后1个月以及术后3个月之间手术源性散光对比,差异无统计学意义(P>0.05)。A组、B组并发症发生率分别为17.02%、14.89%,两组对比,差异无统计学意义(P>0.05)。结论 2.2 mm、2.8 mm角膜切口方式进行白内障超声乳化吸除联合折叠式人工晶状体植入术均具有较好疗效,而对于硬核白内障患者,2.8 mm角膜切口优于2.2 mm角膜切口。

Objective To study the therapeutic effect of phacoemulsification with different lengths of transparentcorneal incision combined with foldable intraocular lens implantation on cataract patients. Methods A total of 94 casesof cataract patients who were admitted in the Department of Ophthalmology of Haining People＇s Hospital from April2013 to August 2015 were selected as the study subjects. The patients were divided into two groups with 47 cases according to the single and double bed number. Group A was reated with cataract phacoemulsification combined withfoldable intraocular lens implantation with a 2.2 mm clear corneal incision. The surgical procedures in group B werethe same as in group A, except that the clear corneal incision was 2.8 mm. The ultrasound emulsification and operationtime were observed between two groups. Postoperative follow-up of patients for 3 months, vision and source sex astigmatism were compared between two groups at preoperative and postoperative 1 week, 1 month, 3 months. And the complications were observed between two groups. Results The phacoemulsification time of nuclear grade Ⅳ in group A wassignificantly longer than that of group B（P〈0.05）. There was no difference between the ultrasound time and operationtime of all other patients（P〉0.05）. There was no difference in visual acuity between the two groups before surgery, at 1week after surgery, 1 month after surgery, and 3 months after surgery（P〉0.05）. There was no difference in operativeastigmatism between the two groups at 1 week, 1 month, and 3 months postoperatively （P〉0.05）. The complication rate in group A and B was 17.02% and 14.89%, respectively. There was no difference between the two groups （P〉0.05）. Conclusion The cataract phacoemulsification combined with foldable intraocular lens implantation with 2.2 mm and 2.8 mmcorneal incisions is effective. For hard nuclear cataract patients, 2.8 mm corneal incision is superior to 2.2 mm cornealincision.