1.8mm角膜微切口与3.0mm角膜切口同轴白内障超声乳化术对角膜内皮及术源性散光的对照观察

Comparative observation of 1.8mm corneal micro incision phacoemulsification and 3.Omm corneal incision phacoemulsification on corneal endothelium and surgical induced astigmatism

目的观察比较白内障超声乳化术1.8mm角膜切口与3.0mm角膜切口对角膜内皮和术源性散光的影响。方法根据不同术式将120例白内障患者随机分为1.8mm切口观察组与3.0mm切口对照组行预劈核超声乳化治疗,观察两组病例平均超声时间,平均超声能量,术前,第1d,1wk,1mo的视力、角膜散光变化、角膜内皮计数等情况。结果观察组和对照组有效超乳时间9.51±1.17,9.48±1.21及平均超乳能量(10.01±1.02)%(9.9±1.19)%比较差异均无统计学意义(P>0.05)。两组术前视力0.11±0.057,0.10±0.012比较无统计学差异(P>0.05),术后第1d两组视力0.376±0.071,0.319±0.14比较有统计学意义(P<0.05);术后1wk;1mo两组视力0.410±0.14,0.356±0.12,0.429±0.15,0.364±0.14比较有统计学意义(P<0.05)。平均角膜散光两组术前0.59±0.25,0.61±0.30比较无统计学意义(P>0.05),术后两组第1d(0.91±0.42,1.15±0.41),1wk(0.76±0.26,0.95±0.24)和1mo(0.66±0.23,0.74±0.25)比较有统计学差异(P<0.05)。角膜内皮计数两组术前2753.32±324.12,2645.36±321.45比较无统计学意义(P>0.05),术后第1d(2412.36±541.12,2397.62±204.21),1wk(2365.35±233.72,2351.36±248.63)和1mo(2298.37±251.89,2209.45±373.07),比较无统计学差异(P>0.05)。结论,1.8mm切口超声乳化术同传统3.0mm切口组比较,不导致超乳效率下降及更多的角膜内皮细胞的损伤,且术后医源性散光相较更小,术后视力更佳。

Objective To observe and compare the effects of phacoemulsification with 1.8mm incision and 3.Omm conventional incision on corneal endothelium and intraoperative astigmatism.t.Methods A total of 120 cataract patients were randomly divided into 1.8mm incision observation group and 3.Omm incision control group for pre-split nucleus phacoemulsification.The mean ultrasound time and mean ultrasound energy of the two groups were observed,before operation,on the first day.Iwk;Visual acuity,changes of corneal astigmatism,corneal endothelium count,etc.Results There was no statistically significant difference(P>0.05)between the observation group and the control group in terms of ffective lactation time(9.51±1.17,9.48±1.21)and average lactation energy(10.01±1.02)%,(9.9±1.19)%.There was no statistically significant difference in preoperative visual acuity(0.11±0.057,0.10±0.012)between the two groups(P>0.05),but there was a statistically significant difference in visual acuity(0.376±0.071,0.319±0.14)between the two groups on the first day after surgery(P<0.05);1 week after surgery;There was statistically significant difference in visual acuity between the two groups(0.410±0.14,0.356±0.12,0.429±0.15,0.364±0.14).The average corneal astigmatism in both groups before surgery(0.59±0.25,0.61±0.30).There was no statistically significant difference(P>0.05)between the two groups on the 1st day after surgery(0.91±0.42,1.15±0.41).There was a statistically significant difference(P<0.05)between 1 week(0.76±0.26,0.95±0.24),and 1 month(0.66±0.23,0.74±0.25).There was no statistically significant difference in corneal endothelial count between the two groups before surgery(2753.32±324.12,2645.36±321.45)(P>0.05).0n the first day after surgery(2412.36±541.12,2397.62±204.21),1 week(2365.35±233.72,2351.36±248.63),and 1 month(2298.37±251.89,2209.45±373.07),there was no statistically significant difference(P>0.05).Conclusion Compared with the traditional 3.0mm incision group,the 1.8mm incision phacoemulsification group did not lead to a decrease in the efficiency of phacoemulsification and more damage to corneal endothelial cells,and the iatrogenic astigmatism was smaller and the postoperative vision was better.