超声乳化术治疗葡萄膜炎并发白内障的临床效果分析

Clinical effect of phacoemulsification in treatment of uveitis complicated with cataract

目的分析葡萄膜炎并发白内障采用超声乳化术治疗的临床疗效。方法2017年4月—2020年6月,于济源市人民医院收治的葡萄膜炎并发白内障患者中选取62例,共62眼,按采用的手术方式不同分为观察组和对照组各31例。采用超声乳化联合人工晶状体植入术治疗的作为观察组,采用小切口无缝线非超声乳化摘除联合后房型人工晶状体植入术治疗的设为对照组,比较两组患者的临床疗效、视力、眼压及晶体混浊程度、并发症发生率。结果超声乳化联合人工晶状体植入术观察组优良率为90.32%,对照组优良率为70.97%,观察组优良率高于对照组,差异有统计学意义(P<0.05);术前3天两组角膜内皮计数、眼压值、中央前房深度和视力差异无统计学意义(P>0.05)。术后观察组角膜内皮计数高于对照组差异有统计学意义(P<0.05),两组眼压值、中央前房深度差异无统计学意义(P>0.05),观察组视力高于对照组差异有统计学意义(P<0.05);术中观察组有3例出现虹膜出血现象,对照组有4例,均出现在分离虹膜粘连的过程中,发生主要原因为黏弹剂作用出血受到局限,但未对手术产生影响;术后7d观察组有1例出现前房闪辉现象,1例前房渗出,1例角膜水肿现象,发生率为9.68%,对照组有3例前房闪辉,2例前房渗出,2例角膜水肿,发生率为22.58%,观察组并发症发生率明显低于对照组差异有统计学意义(P<0.05),两组并发症均治疗3~5d之后自行消退。结论超声乳化术治疗葡萄膜炎并发白内障对改善患者视力有促进作用,临床疗效显著。

Objective To analyze the clinical efficacy of phacoemulsification in the treatment of uveitis complicated cataract.Methods Totally 62 patients with uveitis complicated with cataract admitted to our hospital from April 2017 to June 2020 were selected.A total of 62 eyes were randomly divided into observation group and control group,with 31 cases each.The observation group was treated with phacoemulsification combined with intraocular lens implantation,while the control group was treated with intraocular lens implantation alone.The clinical efficacy,visual acuity,intraocular pressure,degree of intraocular lens opacity,and incidence of complications were compared between the two groups.Results In the observation group,excellent and good rate was 90.32%.In the control group,excellent and good rate was 70.97%.The excellent and good rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in corneal endothelium count,iop,central anterior chamber depth and visual acuity between the two groups three days before surgery(P>0.05).Postoperative observation group corneal endothelium count was higher than that of the control group(P<0.05);There were no statistically significant differences in iop value and central anterior chamber depth between the two groups(P>0.05);Visual acuity of the observation group was higher than that of the control group(P<0.05).There were 3 cases of iris bleeding in the observation group and 4 cases in the control group,all of which occurred in the process of separating iris adhesion.The main reason for the occurrence was that the bleeding caused by viscoelastic agent was limited,but it did not affect the operation.7 d after surgery observation group 1 case of anterior chamber benefly phenomenon,1 case of anterior chamber exudation,1 case of corneal edema,the incidence was 9.68%,in the control group,there were 3 cases of anterior chamber benefly,2 cases of anterior chamber exudation,2 cases of corneal edema,the incidence was 22.58%,the incidence of complications of observation group was obviously lower than that of control group(P<0.05),two groups of complications after treatment for 3~5 d regress.Conclusion The therapeutic effect of phacoemulsification for uveitis complicated cataract is significant,and it can improve the visual acuity of the patients.