巩膜隧道切口白内障囊外摘除与超声乳化术人工晶状体植入对患者术后裸眼视力及角膜散光的影响

Effect of extracapsular catract extraction and phacoemulsificatin with intraocular lens implantation through scleral tunnel incision on uncorrected visual acuity and corneal astigmeatism after cataract surgery

目的探讨巩膜隧道切口白内障囊外摘除与超声乳化术联合人工晶状体植入对白内障患者术后裸眼视力及角膜散光的影响。方法选择2015年6月至2017年12月在我院就诊的白内障患者作为研究对象,采用随机数字表法将60例(60只眼)白内障患者随机分为A组和B组各30例。A组采用巩膜隧道切口白内障超声乳化联合人工晶状体植入术治疗,B组采用巩膜隧道切口白内障囊外摘除联合人工晶状体植入术治疗。观察2组术后3d、1周、1、3个月视力>0.5患者比率,收集术前1d、术后1周、1、3个月角膜散光度数,统计2组并发症发生率。结果2组术后3d、术后1周、术后1、3个月裸眼视力>0.5比率差异均无统计学意义(P>0.05)。A组和B组角膜散光度数组内、组间比较差异均无统计学意义(P>0.05))。2组术后并发症如晶状体后囊膜破裂、虹膜脱出、玻璃体溢出、前房出血发生率相比较差异均无统计学意义(P<0.05);B组术后角膜水肿发生率低于A组,差异有统计学意义(P<0.05)。结论巩膜隧道切口白内障囊外摘除联合人工晶状体植入术治疗白内障较超声乳化手术可减少术后角膜水肿发生率,并且不增加角膜散光度数,在基层医院具有临床推广应用价值。

Objective To investigate the effect of extracapsular cataract extraction and intraocular lens implantation through scleral tunnel incision on postoperative visual acuity and corneal astigmatism after cataract surgery.Methods 60 patients with cataract were randomly diviede in to A group and B group with 30 cases in eash group. The group A was treated with extracapsular cataract extraction and intraocular lens implantation ghrough scleral tunnel incision.The rate of vision higher than 0.5 at 3 d,1week,1 month and 3 months after operation and corneal astigmatism before operation and at 1 week,1 month and 3 months after operation were observed,and the incidence of 2 groups of complicatioins was counted.Results There was no significant difference between the 2 groups in rate of vision higher than 0.5 at 3 d,1 week,1 month and 3months after operation ( P <0.05).There was no significant difference in corneal astigmatism between group A and group B ( P >0.05).There was no significant difference in the incidence of posterior capsule rupture,iris prolapse,vitreous hemorrhage and hyphemia between the 2 groups ( P >0.05).The incidence of corneal edema in group B was lower than that in group A ( P <0.05).Conclusion The extracapsular cataract extraction and intraocular lens implantation through sclear tunnel incision in treatment of cataract have positive clinial effect,not increase corneal astigmatiosm,and ca reduce the incidence of corneal edema after operation,which has the value of clinical promotion.