代谢性白内障与老年性白内障手术联合TORIC晶体植入的临床疗效对比研究

Comparative study of clinical efficacy between metabolic cataract and senile cataract surgery combined with TORIC lens implantation

目的 探讨代谢性白内障与老年性白内障行超声乳化摘除联合Toric晶体植入术临床疗效及安全性比较。方法 随机选取我院2021年1月~2024年3月收治的42例(52眼)代谢性白内障合并角膜规则散光患者(散光≥1.0D),另随机选取同时期收治的45例(52眼)老年性白内障合并角膜规则散光患者(散光≥1.0D),均采取白内障超声乳化联合Toric晶状体植入手术治疗,分别比较两组患者术后1d,1w,1mo,3mo时的视力、散光的矫正及并发症情况。结果 代谢性白内障组的52眼中,术后1d、1w、1mo,3mo时的裸眼视力0.5以上者分别为21眼、30眼、35眼,45眼;而同样时间点散光残留低于0.75D者分别为25眼、33眼、35眼、47眼。老年性白内障组52眼中,术后1d、1w、1mo,3mo时的裸眼视力0.5以上者分别为32眼,41眼、45眼、47眼;而同样时间点散光残留低于0.75D者分别为36眼,44眼、46眼,48眼。两组患者在术后1d,1w,1mo时视力恢复(χ^(2)=4.656,χ^(2)=3.488,χ^(2)=5.417)以及残留散光(χ^(2)=4.789,χ^(2)=6.053,χ^(2)=6.755)比较差异有统计学意义(P<0.05),而两组患者在术后3mo时视力以及残留散光上比较差异无统计学意义(χ^(2)=0.377,P>0.05)。两组患者在术后高眼压发生上比较差异无统计学意义(χ^(2)=0.122,P>0.05)。两组患者在术后1mo并发黄斑囊样水肿并发症上比较差异有统计学意义(χ^(2)=5.626,P<0.05)。结论 伴有角膜规则散光的代谢性白内障与老年性白内障,同样实施白内障超声乳化联合Toric晶体植入,两者术后早期视力恢复及散光矫正效果有差异,而远期手术疗效则无明显差异。

Objective To compare the clinical efficacy and safety of phacoemulsification combined with Toric lens implantation for metabolic cataract and senile cataract.Methods Forty two patients(52 eyes)with metabolic cataracts and regular corneal astigmatism(astigmatism≥1.0D)admitted to our hospital from January 2021 to March 2024 were randomly selected.Another 45patients(52 eyes)with elderly cataracts and regular corneal astigmatism(astigmatism≥1.0D)admitted during the same period were randomly selected.Both groups underwent cataract phacoemulsification combined with Toric lens implantation surgery.The visual acuity,astigmatism correction,and complications of the two groups of patients were compared at 1 day,1 week,1 month,and 3 months after surgery.Results Among the 52 eyes in the metabolic cataract group,21 eyes,30 eyes,35 eyes,and 45 eyes had uncorrected visual acuity of 0.5 or better at 1 day,1 week,1 month,and 3 months after surgery,respectively;At the same time point,there were 25 eyes,33 eyes,35 eyes,and47 eyes with residual astigmatism below 0.75D.Among the 52 eyes in the elderly cataract group,32 eyes,41 eyes,45 eyes,and 47 eyes had uncorrected visual acuity of 0.5 or better at 1 day,1 week,1 month,and 3 months after surgery,respectively;At the same time point,there were 36 eyes,44 eyes,46 eyes,and 48 eyes with residual astigmatism below 0.75D.There was a statistically significant difference(P<0.05)in visual acuity recovery(χ^(2)=4.656,χ^(2)=3.488,χ^(2)=5.417)and residual astigmatism(χ^(2)=4.789,χ^(2)=6.053,χ^(2)=6.755)between the two groups of patients at 1 day,1 week,and 1 month after surgery.However,there was no statistically significant difference(χ^(2)=0.377,P>0.05)in visual acuity and residual astigmatism between the two groups of patients at 3 months after surgery.There was no statistically significant difference(χ^(2)=0.122,P>0.05)in the occurrence of postoperative high intraocular pressure between the two groups of patients.There was a statistically significant difference(P>0.05)in the incidence of complications of macular cystic edema between the two groups of patients at 1 month after surgery(χ^(2)=5.626,P<0.05).Conclusion Metabolic cataracts with regular corneal astigmatism and senile cataracts,when treated with cataract phacoemulsification combined with Toric lens implantation,show differences in early postoperative visual recovery and astigmatism correction between the two groups,while there is no significant difference in long-term surgical efficacy.