不同方式的白内障手术对老年患者术后眼内炎以及预后的不良影响

Adverse Effects of Different Methods of Cataract Surgery on Postoperative Endophthalmitis and Prognosis of Elderly Patients

目的:探讨不同方式的白内障手术对老年患者术后眼内炎以及预后的不良影响。方法:选取2017年5月至2019年5月期间,在我院眼科手术治疗的白内障患者1636例(1645眼)为研究对象,按照手术方式进行分为超声乳化组828例(843眼)和囊外摘除组808例(802眼)。采用回顾性分析对白内障患者临床特征进行对比分析,应用Logistic回归分析白内障患者的术后感染眼内炎的多因素的影响。结果:超声乳化组与囊外摘除组患者的性别、高血压病、糖尿病、术前视力、眼压的临床指标对比,均无显著性差异(P>0.05)。眼内感染患者的年龄、糖尿病、手术方式、玻璃体溢出、手术时间、切口长度均具有显著性差异(P<0.05)。白内障患者的年龄(≥65岁)、糖尿病、囊外摘除术、玻璃体溢出、手术时间(≥15min)、切口长度(≥5mm)均是白内障患者术后感染眼内炎的危险因素(P<0.05)。结论:两种手术方式均能改善白内障患者的眼压及视力,但超声乳化术整体疗效优于传统手术方式,极大的改善了患者术后眼内炎发生率。

Objective:To explore the adverse effects of different methods of cataract surgery on postoperative endophthalmitis and prognosis of elderly patients.Methods:From May 2017 to May 2019,1636 patients(1645 eyes)with cataract treated in our hospital were selected as the research objects.According to the operation methods,they were divided into phacoemulsification group of 828 cases(843 eyes)and extracapsular enucleation group of 808 cases(802 eyes).Retrospective analysis was used to compare the clinical characteristics of cataract patients,and logistic regression was used to analyze the multi-factor influence of postoperative endophthalmitis in cataract patients.Results:There was no significant difference between the phacoemulsification group and the extracapsular enucleation group in the clinical indicators of gender,hypertension,diabetes,preoperative vision,and intraocular pressure(P>0.05).The age,diabetes,operation method,vitreous overflow,operation time,and incision length of patients with intraocular infection were significantly different(P<0.05).The age of cataract patients(≥65 years),diabetes,extracapsular resection,vitreous overflow,operation time(≥15min),incision length(≥5mm)are all risk factors for postoperative endophthalmitis in cataract patients(P<0.05).Conclusion:Both surgical methods can improve the intraocular pressure and visual acuity of cataract patients,but the overall effect of phacoemulsification is better than traditional surgical methods,which greatly improves the incidence of postoperative endophthalmitis.