不同劈核方法对假性剥脱综合征性白内障手术的疗效观察

Observation on the clinical efficacy of two manual chopping methods for cataract combined with pseudoexfoliation syndrome

目的观察不同劈核方法治疗维吾尔族患者假性剥脱综合征(PEX)白内障的临床疗效。方法回顾性研究。选取2018年10月至2019年10月在中国人民解放军新疆军区总医院全军眼科中心行超声乳化手术治疗的维吾尔族患者PEX性白内障122例(122眼), 根据手术方式分为两组:拦截劈核病例作为观察组, 60例(60眼);预劈核病例作为试验组, 62例(62眼)。比较两组术后1 d、1周及3个月的视力、角膜水肿及角膜内皮损失率情况。结果观察组平均有效超声时间为(14.50±5.63)s, 较试验组(12.32±7.34)s长(t=15.12, P<0.05);试验组术后1 d、1周的视力优于观察组(Z=-5.070, -6.230;均P<0.001), 术后1 d、3 d的角膜水肿程度低于观察组(Z=-3.490, -3.710;均P<0.001)。试验组角膜内皮丢失率较观察组较少(t=2.110, P=0.001)。结论与拦截劈核相比较, 预劈核技术在维吾尔族PEX患者白内障术中超声时间较短、能量较低、角膜内皮细胞丢失率较少, 视力恢复较快。

Objective To observe the clinical efficacy of two manual chopping methods for cataract combined with pseudoexfoliation syndrome in Uygur patients.Methods This was a retrospective clinical study.The data of 122 eyes of 122 Uygur patients with cataract combined with pseudoexfoliation syndrome were enrolled from Oct.2018 to Oct.2019 in Military District General Hospital of Chinese People’s Liberation Army.The patients were divided into two groups according to the surgery methods.There were 60 eyes of 60 cases in the phaco-chop group as observation group and 62 eyes of 62 cases in the phacoemulsification pre-chop group as trial group.The follow-up time was 3 months.The visual acuity,degree of comeal edema and rate of endothelial loss between the two groups at 1 day,1 week and 3 months were compared.Results The mean effective phaco durations in the observation group was(14.50±5.63)s,which was longer than the(12.32±7.34)s in the trial group(t=15.12,P<0.05).The visual acuity of the trial group was better than that of the observation group at 1 day and 1 week after operation(Z=-5.070,-6.230;all P<0.001).And the degree of corneal edema at 1 day and 3 day after operation was lower than that of the observation group(Z=-3.490,-3.710;all P<0.001).The rate of corneal endothelial loss was less in trial group than in the observation group(t=2.110,P=0.001).Conclusion Compare with divide and conquer technique,the pre-chop phaco technique has less impact on zonule,utilized less phaco time,energy,and lighten the postoperative damage of corneal endothelial cells and accelerate visual rehabilitation.