白内障2.2 mm角膜微切口超声乳化术的效果分析

Analysis of the efficacy of phacoemulsification with 2.2 mm corneal microincision for cataract

目的评价2.2 mm角膜微切口超声乳化治疗年龄相关性白内障的效果。方法采用回顾性研究,以2018年10月至2020年9月徐州复兴眼科医院年龄相关性白内障91例(91眼)作为研究对象,患者根据不同手术切口分为两组:对照组45例(45眼),采用3.0 mm小切口白内障超声乳化手术;观察组46例(46眼),采用2.2 mm角膜微切口超声乳化术。随访3周,观察超声乳化时间及能量、角膜内皮功能、泪膜破裂时间、泪液分泌试验结果、角膜荧光素染色评分(SCSF)、视力和散光。并进行两组比较。结果观察组平均超声乳化时间、有效超声乳化时间及超声乳化能量分别为(17.6±1.8)s、(7.3±1.9)s及(42.0±3.4)%,与对照组(41.8±3.2)s、(17.2±1.5)s、(7.5±2.1)s及(41.8±3.2)%、相比差异无统计学意义(t=0.28、0.477、1.150,P=0.389、0.317、0.127)。术后观察组泪膜破裂时间、泪液分泌试验结果及SCSF评分分别为(9.5±2.1)s、(14.2±2.2)mm/5 min及(5.2±1.1)分,均优于对照组的(7.2±1.7)s、(16.5±2.5)mm/5 min及(6.3±1.5)分(t=5.735、4.662、3.995,均P<0.01)。术后观察组角膜内皮细胞密度、中央角膜厚度及角膜内皮细胞变异系数分别为(2511.9±91.2)个/mm^(2)、(557.2±10.3)μm及(29.9±2.4)%,与对照组(2356.9±85.2)个/mm^(2)、(575.2±13.8)μm及(31.5±2.5)%(t=-8.374、7.062、3.115,均P<0.001)。术后观察组散光(1.1±0.2)D低于对照组的(1.4±0.3)D(t=5.624,P<0.01)。术后1 d及3周观察组视力≥0.5患者占比89.1%及93.5%,高于对照组71.1%及75.6%(t=4.655,5.613;P=0.031,0.018)。结论年龄相关性白内障2.2 mm角膜微切口超声乳化术较3.0 mm切口者效果更好。

Objective To evaluate the efficacy of phacoemulsification with 2.2 mm corneal microincision in the treatment of age-related cataract.Methods This was a retrospective study.Total of 91 eyes of 91 cases of age-related cataract in Xuzhou Fuxing Ophthalmic Hospital from Oct.2018 to Sep.2020 were taken as the research objects.These patients were divided into two groups based on different surgical incisions.Forty-five eyes of 45 cases in the control group were treated with 3.0 mm small incision phacoemulsification,and 46 eyes of 46 cases in the observation group were treated with 2.2 mm corneal microincision phacoemulsification.The follow-up time was 3 weeks after operation.The pacoemulsification time and energy,corneal endothelium function,the tear break-up time(BUT),Schimer I test and corneal fluorescein sodium staining score(SCSF)and visual acuity,astigmatism were observed.And the efficacy between the two groups were compared.Results The average phacoemulsification time,effective phacoemulsification time and phacoemulsification energy in the observation group were(42.0±3.4)s,(7.3±1.9)s and(17.6±1.8)s,respectively.There was no significant difference compared with(41.8±3.2)s,(7.5±2.1)s and(17.2±1.5)s of the control group(t=0.280,0.477,1.150;P=0.389,0.317,0.127).The BUT,SchimerⅠtest and SCSF scores in the observation group were(9.5±2.1)s,(14.2±2.2)mm/5min and(5.2±1.1)scores respectively,which were better than those(7.2±1.7)s,(16.5±2.5)mm/5 min and(6.3±1.5)scores in the control group(t=5.735,4.662,3.995;all P<0.01).The corneal endothelial cell density,central corneal thickness and coefficient of variation of corneal endothelial cells in the observation group were(2511.9±91.2)cell/mm^(2),(557.2±10.3)μm and(29.9±2.4)%respectively,that of the control group was(2356.9±85.2)/mm^(2),(575.2±13.8)μm and(31.5±2.5)%respectively(t=8.374,7.062,3.115;P<0.001).The astigmatism was(1.1±0.2)D in the observation group,which was lower than the(1.4±0.3)D in the control group(t=5.624,P<0.001).At 1 day and 3 weeks after operation,89.1%and 93.5%of the patients with visual acuity≥0.5 in the observation group were higher than 71.1%and 75.6%in the control group(t=4.655,5.613;P=0.031,0.018).Conclusion Phacoemulsification with 2.2 mm corneal microincision has better efficacy compared with 3.0 mm incision for the treatment of age-related cataract.