同轴微切口白内障超声乳化术治疗白内障的临床效果

Clinical effect of coaxial micro-incision cataract ultrasonic phacoemulsification in the treatment of cataract

目的探讨同轴微切口白内障超声乳化术治疗白内障的临床效果。方法选取我院2017年5月至2020年9月收治的300例白内障患者(385眼),按照随机数字表法将其分为对照组(150例,190眼,双手微切口白内障超声乳化术)和研究组(150例,195眼,同轴微切口白内障超声乳化术)。比较两组的前房稳定情况、角膜水肿发生情况、最佳矫正视力、角膜内皮细胞密度、手术性散光度、房水内炎性介质水平及泪膜功能。结果两组的角膜褶皱、前房塌陷发生率比较,差异均无统计学意义(P>0.05)。术后1、3、7 d,研究组的角膜水肿发生率均低于对照组,差异具有统计学意义(P<0.05)。术后7 d,研究组的最佳矫正视力、角膜内皮细胞密度均高于对照组,差异具有统计学意义(P<0.05)。术后1、3、7 d,研究组的手术性散光度数均低于对照组,差异具有统计学意义(P<0.05)。术后3 d,研究组的白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平低于对照组,差异具有统计学意义(P<0.05)。术后7 d,研究组的泪膜破裂时间(BUT)、基础泪液分泌实验(SⅠT)长于对照组,角膜荧光素染色(FLS)低于对照组,差异具有统计学意义(P<0.05)。结论同轴微切口白内障超声乳化术治疗白内障的效果显著,可减轻对患者角膜内皮的损伤,降低术后角膜水肿发生率,提高视力,减轻术后炎症反应,保护患者泪膜功能。

Objective To investigate the clinical effect of coaxial micro-incision cataract ultrasonic phacoemulsification in the treatment of cataract.Methods A total of 300 cataract patients(385 eyes)admitted in our hospital from May 2017 to September 2020 were selected and divided into control group(150 cases,190 eyes,double hand microincision cataract ultrasonic phacoemulsification)and study group(150 cases,195 eyes,coaxial micro-incision cataract ultrasonic phacoemulsification)according to the random number table method.The anterior chamber stability,occurrence of corneal edema,best corrected visual acuity,corneal endothelial cell density,surgical astigmatism,inflammatory mediators levels in aqueous humor and tear film function were compared between the two groups.Results There were no significant differences in the incidences of corneal folds and anterior chamber collapse between the two groups(P>0.05).At 1,3 and 7 d after operation,the incidence of corneal edema in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).At 7 d after operation,the best corrected visual acuity and corneal endothelial cell density of the study group were higher than those of the control group,and the differences were statistically significant(P<0.05).At 1,3 and 7 d after operation,the surgical astigmatism of the study group was lower than that of the control group,and the difference was statistically significant(P<0.05).At 3 d after operation,the levels of interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the study group were lower than those of the control group,and the differences were statistically significant(P<0.05).At 7 d after operation,the break-up time(BUT)and schirmerⅠtest(SⅠT)of the study group were longer than those of the control group,the fluorescein vital staining(FLS)of the study group was lower than that of the control group,and the differences were statistically significant(P<0.05).Conclusion The coaxial micro-incision cataract ultrasonic phacoemulsification in the treatment of cataract has a significant effect.It can alleviate the damage to the corneal endothelium,reduce the incidence of postoperative corneal edema,improve visual acuity,alleviate postoperative inflammatory response and protect the tear film function of patients.