2.2mm同轴微切口白内障超声乳化术的临床应用

Clinical Application of 2.2mm Coaxial Micro Incision Phacoemulsification

目的观察2.2 mm同轴微切口白内障超声乳化手术的临床疗效.方法选取昆明医科大学第五附属医院眼科2011年6月至2013年5月间收治的年龄相关性白内障(核硬度Ⅰ~Ⅲ级)患者71例(83眼),随机分为2组,A组:实验组35例(41眼),使用2.2 mm同轴微切口扭动白内障超声乳化术,B组:对照组36例(42眼),使用3.0 mm常规切口扭动白内障超声乳化术.观察超声乳化手术过程中前房稳定性,记录超声乳化时间平均累积释放能量(CDE)及手术并发症发生情况,随访患者术后第1d、7d、30d,记录视力、角膜水肿情况及平均手术源性散光.结果 (1)2组患者术中前房稳定性良好;2组手术均未发生并发症;(2)2组手术超声乳化晶状体核的时间分别为:A组(50±25)s,B组(48±23)s,差异无统计学意义(P>0.05);平均累积释放能量(CDE):A组(8~23)%,B组(7~22)%,差异无统计学意义(P>0.05);(3)术后第1天最佳矫正视力(BCVA)大于0.5的患者分别为85.36%、73.80%,术后第7天与第30天2组视力差异无统计学意义(P>0.05).(4)角膜散光度:A组术后第7天及30天均小于B组,差异无统计学意义(P>0.05).结论 2.2 mm同轴微切口白内障超声乳化术具有切口更小、恢复更快及手术源性散光更小等特点,具有广泛的临床应用价值和前景.

Objective To observe the clinical efficacy of2.2mm coaxial micro incision phacoemulsificationsurgery.Methods From June2011to May2013,71cases(83eyes)age-related cataract(nuclear hardnessⅠ-Ⅲ)patients were randomly divided into two groups.Group A:experimental group35cases(41eyes)withusing2.2mm coaxial microincisional twist cataract phaco.Group B:the control group36cases(42eyes)withusing3.0mm twist conventional incision cataract phaco.The anterior chamber stabilities were observed and theaverage cumulative release energy(CDE)of ultrasonic emulsification time and surgical complications wererecorded during phacoemulsification operation.In addition,vision,corneal edema and average surgically inducedastigmatism were also recorded1day,7days,30days postoperatively with follow-up patients.ResultsStatistical data were obtained by using spss19.0software packet analysis,chi-square test and t test.(1)Intraoperative anterior chamber stabilities were good in two groups.And there were no surgical complications.(2)There was no statistical difference between the ultrasonic time of lens nucleus emulsion and the average cumulativerelease energy in two intraoperative groups.(3)The difference of the best corrected visual acuity(BCVA)of postoperative1day was statistically significant.But there was no significant difference between the two groups after7days and30days.(4)The difference was statistically significant in corneal astigmatism.Conclusion The2.2mmcoaxial micro incision phacoemulsification surgery has extensive applied value and prospect in clinic for its smallerincision,faster recovery and smaller surgically induced astigmatism.