MSICS术与PE术治疗老年白内障的临床疗效及对泪膜功能和术后并发症的影响

Clinical effect of MSICS and PE in the treatment of senile cataract and its effect on the function of tear film and postoperative complications

目的观察老年白内障患者临床治疗现状,行手法小切口白内障摘除手术(manual small incision cataract surgery,MSICS)与超声乳化白内障吸除术(phacoemulsification,PE)进行治疗,分析两种术式对患者泪膜功能、术后并发症等的影响。方法借助统计软件将2019年1月至2019年12月期间在本院接受手术治疗的60例老年白内障患者分为两组,对照组接受PE术治疗,研究组接受MSICS术治疗,对比两组手术前后泪膜功能、并发症及视力改善情况。结果两组患者手术前泪膜功能各指标评价差异均无统计学意义(均P>0.05),研究组手术30 d后泪膜功能各指标评价均优于对照组[BUT:(4.99±1.15)s比(3.50±1.07)s;SIt:(15.70±3.02)mm比(17.65±3.56)mm;SDES:(1.19±0.35)分比(1.43±0.39)分](均P<0.05)。研究组患者手术后并发症发生率[10.00%(3/30)]低于对照组[43.33%(13/30)](P<0.05)。两组患者手术后不同时间视力改善情况评价差异均无统计学意义(均P>0.05)。结论老年白内障患者临床接受MSICS术与PE术治疗,均能有效改善视力情况,但MSICS术治疗较PE术治疗对泪膜功能影响更小,且手术后并发症率低,临床应 用优势更加明显。

Objective To observe the present situation of clinical treatment of senile cataract patients,who were treated by manual small incision cataract surgery(MSICS)and phacoemulsification(PE),and analyze the effects of the two operations on the function of tear film and postoperative complications.Methods With the help of statistical software,60 elderly cataract patients who received surgical treatment in our hospital from January 2019 to December 2019 were divided into two groups:the control group received PE surgery,and the study group received MSICS surgery.The function of tear film before and after surgery,postoperative complications,and vision improvement were compared between the two groups.Results Tear film function indexes were not significantly different in the two groups before surgery(all P>0.05);tear film function indexes in the study group 30 days after surgery were better than those in the control group[BUT:(4.99±1.15)s vs.(3.50±1.07)s;Sit:(15.70±3.02)mm vs.(17.65±3.56)mm;SDES:(1.19±0.35)points vs.(1.43±0.39)points](all P<0.05).The rate of postoperative complications of the study group was lower than that of the control group[10.00%(3/30)vs.43.33%(13/30)](P<0.05).There was no statistically significant difference in the evaluation of visual acuity improvement between the two groups at different time points after surgery(all P>0.05).Conclusion Clinical treatment with MSICS and PE can effectively improve the eyesight of elderly cataract patients,but compared with PE treatment,MSICS treatment has less impact on the tear film function,with lower rate of postoperative complications,and more obvious clinical application advantages.