外伤性白内障不同手术时机人工晶状体植入术疗效分析

Clinical Efficacy of Intraocular Lens Implantation at Different Timing in the Treatment of Traumatic Cataract

目的 探讨外伤性白内障患者行人工晶状体植入术的最佳手术时机。方法 选取2015年1月至2020年10月盘锦市中心医院收治的70例外伤性白内障患者作为研究对象,按照随机数表法将其随机分为早期组与晚期组,每组35例,早期组患者于伤后1周内行白内障摘除联合人工晶状体植入术治疗,晚期组患者于伤后1~2个月行白内障摘除联合人工晶状体植入术治疗,对比两组患者手术时间、术中出血量、住院时间以及患眼视力情况与术后并发症发生情况。结果 早期组患者手术时间、住院时间均长于晚期组(t=2.951、2.310,P=0.004、0.024);术中出血量与晚期组无明显差异(t=1.651,P=0.103)术后1个月,两组患者患眼视力均较术前明显提高(χ^(2)=10.205、19.890,P=0.006、P<0.001),且两组间无明显差异(χ^(2)=1.659,P=0.436)早期组患者术后并发症发生率为22.86%,明显高于晚期组患者的术后并发症发生率5.71%(χ^(2)=4.200,P=0.040)。结论 早期、晚期人工晶状体植入术治疗外伤性白内障均可明显改善患者视力,具有相同的治疗效果,但晚期行人工晶状体植入术的患者并发症发生率更低,术后转归效果更佳。

Objective To investigate the optimal time of performing intraocular lens implantation for patients with traumatic cataract.Methods 70 patients with traumatic cataract,admitted to Panjin Central Hospital from January 2015 to October 2020,were enrolled as research subjects and divided,using the random number table,into early stage group(n=35) and late stage group(n=35).Patients in early-stage group were given cataract surgery and intraocular lens implantation within one week after injury,while patients in late-stage group received cataract surgery and intraocular lens implantalion 1-2 months after injury.The operation time,intraoperative blood loss,length of stay,visual acuity of the affected eye,and postoperative complications were compared between the two groups.Results The operation time and length of stay in early stage group were both longer than late stage group(t=2.951 and 2.310,P=0.004 and 0.024),and there was no statistically significant difference between the two groups in terms of intraoperative blood loss(t=1.651,P=0.103).One month after surgery,the visual acuity of patients all improved in the two groups compared with the levels before surgery(χ^(2)=10.205 and 19.890,P=0.006 and P <0.001),and the improvement showed no significant difference between the two groups(χ^(2)= 1.659,P=0.436).The incidence of complications after surgery in early state group was 22.86%,much higher than 5.71 % in late stage group(χ^(2)-4.200,P=0.040).Conclusion In the treatment of traumatic cataract,intraocular lens implantation preformed at the early stage and late stage both can significantly improve patients’ visual acuity and realize same surgical effects,but patients with late-stage intraocular lens implantation have a lower incidence of complications and better postoperative outcomes.