超声乳化联合人工晶体植入术对外伤性晶体半脱位的疗效观察

Clinical Observation of Ultrasound Phacoemulsification and Intraocular Lens Implantation in the Treatment of Traumatic Lens Subluxation

目的:探究外伤性晶体半脱位患者在使用超声乳化联合人工晶体植入术后效果。方法:研究对象为坦桑尼亚桑给巴尔岛那兹莫加医院眼科中心2015年6月-2017年3月收治的36例(36只眼)外伤性晶体半脱位患者,用随机排列表法分为观察组与对照组,18例(18只眼)采用超声乳化联合人工晶体植入术作为观察组,另18例(18只眼)采用晶体行囊内或囊外摘除及后房型人工晶体巩膜缝线固定法作为对照组。比较两组患者实施不同治疗对眼压、视力、并发症的影响。结果:经过观察两组治疗效果可以看出,在眼压上,术前两组比较差异无统计学意义(t=0.214,P>0.05),观察组术后24 h、术后72 h、术后1周与对照组相比,眼压均降低显著(t=-4.588、-4.997、-6.126,P<0.05);在视力上,术前两组比较差异无统计学意义(t=-1.177,P>0.05),观察组术后24 h、术后72 h、术后1周与对照组相比,视力均恢复显著较好(t=15.240、16.122、12.944,P<0.05);且不良反应发生率观察组(11.11%)显著比对照组(27.78%)低(字2=8.870,P<0.05)。结论:外伤性晶体半脱位患者在进行超声乳化联合人工晶体植入术后,能显著降低不良反应发生率,提升视力恢复,稳定眼压,此方法值得应用与推广。

Objective:To explore the clinical effect of ultrasound phacoemulsification and intraocular lens implantation in the treatment of traumatic lens subluxation.Method:36 patients with traumatic lens subluxation from June 2015 to March 2017 treated in Ophthalmology Department of Abdallah Mzee Hospital,Zanzibar Island,The United Republic of Tanzania were selected.The subjects were randomly divided into the observation group(18 cases,18 eyes)and the control group(18 cases,18 eyes).The observation group adopted the combined method of ultrasound phacoemulsification and intraocular lens implantation,the control group adopted the intracapsular or extracapsular extraction and transscleral suture fixation of posterior chamber of intraocular lens.After treatment,the intraocular pressure,vision and the incidence rate of complications of two groups were compared.Result:Before surgery,the intraocular pressure of two groups was not significantly different(t=0.214,P>0.05).After 24 h,72 h and 1 week of surgery,the intraocular pressure of the observation group were significantly lower than those of the control group(t=-4.588,-4.997,-6.126,P<0.05).Before surgery,the vision of two groups was not significantly different(t=-1.177,P>0.05).After 24 h,72 h and 1 week of surgery,the visions of the observation group were significantly better than those of the control group(t=15.240,16.122,12.944,P<0.05).The adverse event rate of the observation group was 11.11%,it was significantly lower than 27.78%of the control group(字2=8.870,P<0.05).Conclusion:For patients with traumatic lens subluxation,the combined method of ultrasound phacoemulsification and intraocular lens implantation can greatly reduce the adverse event rate,improve the recovery of the visions and maintain the intraocular pressure.It is worthy of clinical application and promotion.