小切口白内障囊外摘除联合人工晶体植入术治疗白内障的效果

Effect of small incision extracapsular cataract extraction combined with intraocular lens implantation in the treatment of cataract

目的研究小切口白内障囊外摘除联合人工晶体植入术治疗白内障的效果。方法选取医院收治的240例(279眼)白内障患者,以随机数表法分为观察组120例(140眼)与对照组120例(139眼)。观察组行小切口白内障囊外摘除联合人工晶体植入术治疗,对照组行白内障超声乳化吸出联合人工晶体植入术治疗。比较两组患者手术前、后的视力、散光、泪液分泌情况、CLVQOL评分及并发症发生率。结果两组术前的视力、散光、泪液分泌比较无显著差异(P>0.05);术后7、14 d,两组患者的视力均改善,且观察组术后7 d的视力明显优于对照组(P<0.05);术后7、14 d,两组患者散光、泪液分泌均显著优于术前(P<0.05),但组间比较,差异不显著(P>0.05)。术后,两组读和精细动作、调节能力、远视力、移动和光感、日常生活能力评分及总分均高于术前(P<0.05),组间比较,差异不显著(P>0.05)。观察组术后角膜水肿发生率显著低于对照组(P<0.05);两组术后后囊破裂、瞳孔变形、前房渗出发生率无显著差异(P>0.05)。结论相对于白内障超声乳化吸出联合人工晶体植入术,小切口白内障囊外摘除联合人工晶体植入术治疗白内障术后早期视力恢复更理想,角膜水肿发生率低,是治疗白内障的有效方法,值得临床推广。

Objective To study the effect of small incision extracapsular cataract extraction combined with intraocularlens implantation in the treatment of cataract. Methods Two hundred and forty cases （279 eyes） of cataract patientsadmitted in the hospital were divided into observation group （120 cases, 140 eyes） and control group （120 cases, 139 eyes）according to the random number table method. The observation group was treated with small incision extracapsular cataractextraction combined with intraocular lens implantation, and the control group was treated with phacoemulsificationcombined with intraocular lens implantation. The visual acuity, astigmatism, tear secretion and CLVQOL scores before andafter operation, postoperative complications were compared between the two groups. Results There were no significantdifferences in visual acuity, astigmatism and tear secretion between the two groups before operation （P〉0.05）. At 7 and 14days after operation, the visual acuity of the two groups improved, and the visual acuity of the observation group wassignificantly better than that of the control group at 7 days after operation（P〈0.05）. At 7 and 14 days after operation, theastigmatism and tear secretion in the two groups significantly better than those before operation（P〈0.05）, but there were nosignificant differences between the two groups （P〉0.05）. The scores of reading and fine movement, accommodation ability,distant vision, movement and light perception, daily living ability and total scores of the two groups were higher than thosebefore surgery （P〈0.05）, but there were no significant differences between the two groups （P〉0.05）. The incidence ofcorneal edema in the observation group was significantly lower than that in the control group （P〈0.05）. There were nosignificant differences in the incidences of posterior capsule rupture, pupil deformation and anterior chamber exudation between the two groups （P 〉0.05）. Conclusion Compared with phacoemulsification combined with intraocular lensimplantation, small incision extracapsular cataract extraction combined with intraocular lens implantation in the treatmentof cataract has better postoperative early visual acuity. The incidence of corneal edema is low. It is an effective method forthe treatment of cataract. It is worthy of clinical promotion.