小切口水平空间劈核术联合Toric IOL植入术治疗硬核年龄相关性白内障的临床效果

Clinical Efficacy of Small Incision Horizontal Space Nuclear Splitting and Toric IOL Implantation Surgery in the Treatment of Hard Core Age-related Cataracts

目的:探讨硬核年龄相关性白内障(ARC)患者给予小切口水平空间劈核术联合散光矫正型人工晶状体(Toric IOL)植入术治疗的临床效果。方法:选取2017年1月—2023年12月航天中心医院收治的300例硬核ARC患者,以随机数字表法分成研究组与对照组,各150例。研究组给予小切口水平空间劈核术联合Toric IOL植入术治疗,对照组给予超声乳化术联合Toric IOL植入术治疗。比较两组视力水平、泪膜功能、角膜内皮细胞指标、生活质量及并发症。结果:术后12周,两组视力水平、低视力者生活质量量表(LVQOL)评分均高于术前,且研究组均高于对照组,差异均有统计学意义(P<0.05)。术后1周,两组眼表疾病指数(OSDI)评分、角膜内皮细胞面积(ECA)均高于术前,泪膜破裂时间(BUT)、六角形细胞比例、角膜内皮细胞密度(ECD)均低于术前,但研究组BUT、六角形细胞比例、ECD均高于对照组,OSDI评分、ECA均低于对照组,差异均有统计学意义(P<0.05)。研究组并发症发生率为6.00%,低于对照组的16.67%,差异有统计学意义(P<0.05)。结论:硬核ARC患者给予小切口水平空间劈核术联合Toric IOL植入术治疗,能够改善视力水平,对患者泪膜功能、角膜内皮细胞指标产生的影响较小,还可提高生活质量,降低并发症发生率。

Objective:To investigate the clinical effect of small incision horizontal space nuclear splitting combined with Toric intraocular lens(Toric IOL)implantation surgery in patients with hard core age-related cataract(ARC).Method:A total of 300 hard core ARC patients admitted to Aerospace Center Hospital from January 2017 to December 2023 were selected and divided into study group and control group by random number table method,with 150 patients in each group.The study group was treated with small incision horizontal space nuclear splitting combined with Toric IOL implantation surgery,and the control group was treated with phacoemulsification combined with Toric IOL implantation surgery.Visual acuity level,tear film function,corneal endothelial cell index,quality of life and complications were compared between the two groups.Result:At 12 weeks after surgery,the visual acuity level and low vision quality of life scale(LVQOL)score in two groups were higher than those before surgery,and those in the study group were higher than those in the control group,the differences were statistically significant(P<0.05).One week after surgery,ocular surface disease index(OSDI)score,corneal endothelial cell area(ECA)in the two groups were higher than those before surgery,break up time(BUT),proportion of hexagonal cells and corneal endothelial cell density(ECD)in the two groups were lower than those before surgery,but BUT,proportion of hexagonal cells and ECD in the study group were higher than those in the control group,OSDI score and ECA in the study group were lower than those in control group,the differences were statistically significant(P<0.05).The complication rate of the study group was 6.00%,which was lower than 16.67%of the control group,the difference was statistically significant(P<0.05).Conclusion:Small incision horizontal space nuclear splitting combined with Toric IOL implantation surgery can improve visual acuity,have little effect on tear film function and corneal endothelial cell indexes,improve quality of life and reduce the incidence of complications in patients with hard core ARC.