白内障超声乳化吸除与白内障囊外摘除联合植入PMMA人工晶状体对比研究

Comparative study of phacoemulsification cataract extraction and extracapsular cataract extraction combined with PMMA intraocular lens implantation

目的探讨白内障超声乳化吸除与白内障囊外摘除联合植入聚甲基丙烯酸甲酯(PMMA)人工晶状体治疗白内障的效果。方法选择2019年1月至2020年1月200例于本院治疗的白内障患者,按随机数字表法分为两组,每组100例。对照组行白内障囊外摘除(ECCE)联合人工晶状体(IOL)植入,观察组行白内障超声乳化吸除(PHACO)联合IOL植入。对比两组手术前后视力、视功能量表评分及并发症。结果两组术前视力比较,差异无统计学意义(P> 0.05);两组术后<0.05、0.05-0.2患者占比均下降,观察组0.3-0.5、0.6-1.0占比略高于对照组,但两组术后视力比较,差异无统计学意义(P> 0.05)。两组术后1周的视功能量表各维度评分均较本组术前升高,且观察组高于对照组,差异有统计学意义(P <0.05)。观察组黄斑囊样水肿、角膜水肿、虹膜粘连及纤维素样渗出发生率均较对照组低,差异有统计学意义(P <0.05);两组后囊膜浑浊发生率比较,差异无统计学意义(P> 0.05)。结论 PHACO、ECCE治疗白内障可发挥确切效果,但在两种术式都植入PMMA硬片晶体的情况下,两种术式对患者视力改善没有明显区别,临床应依据实际情况选择术式。

Objective To explore the effect of phacoemulsification cataract extraction and extracapsular cataract extraction combined with polymethylmethacrylate(PMMA)intraocular lens on cataract. Methods From January 2019 to January 2020, 200 cases of cataract patients treated in our hospital were divided into two groups according to the random number table method, with 100 cases in each group.The control group underwent modern extracapsular extraction(ECCE)combined with implantation of intraocular lens(IOL), and the observation group underwent phacoemulsification(PHACO)combined with IOL. The visual acuity level, visual function scale score and complications of the two groups before and after operation were compared. Results The preoperative visual acuity level of the two groups were compared, and the difference was not statistically significant(P > 0.05);the proportion of patients who were < 0.05 and 0.05-0.2 after operation in both groups decreased, and the observation group was 0.3-0.5, 0.6-1.0 slightly higher than the control group, but the difference in postoperative visual acuity between the two groups was not statistically significant. The visual function scale scores of the two groups at 1 week after surgery were higher than those of this group before surgery, and the observation group was higher than the control group, the difference was statistically significant(P < 0.05). The incidence of macular cystoid edema, corneal edema, iris adhesion and cellulose-like exudation in the observation group was lower than that in the control group, the difference was statistically significant(P < 0.05);the incidence of posterior capsule turbidity was compared between the two groups, and the difference was not statistically significant(P > 0.05).Conclusion PHACO and ECCE can play a definite effect in the treatment of cataract, but there is no significant difference in the improvement of visual acuity between the two methods when both methods are implanted with PMMA rigid lens. Therefore, the operation method should be selected according to the actual situation.