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非超声乳化小切口手术和超声乳化吸除术对后囊膜下白内障的临床效果比较(1)
http://www.100md.com 2017年4月25日 《中国实用医药》 2017年第12期
     【摘要】 目的 比较非超声乳化小切口手术与超声乳化吸除术治疗后囊膜下白内障的效果。方法 80例后囊膜下白内障患者, 随机分为对照组和研究组, 各40例。对照组予以非超声乳化小切口手术治疗, 研究组予以超声乳化吸除术治疗, 比较两组患者的手术并发症情况、术后视力以及角膜水肿程度。结果 研究组并发症发生率为10.00%, 低于对照组的37.50%, 差异有统计学意义(P<0.05)。术后随访3个月中, 术后第1周术眼视力恢复到0.5以上的, 研究组有22例, 占55.00%;对照组有13例, 占32.50%;术后第3个月恢复到0.5以上的, 研究组有35例, 占87.50%;对照组有24例, 占60.00%;研究组的术后视力恢复情况优于对照组, 差异有统计学意义(P<0.05)。术后1周及术后3个月, 研究组角膜水肿0级患者比例均高于对照组, 差异有统计学意义(P<0.05)。结论 超声乳化吸除术比小切口非超声乳化手术在术后视力的恢复上更理想, 手术并发症少, 角膜水肿轻, 足以说明超声乳化吸除术在后囊膜下白内障的治疗优势。

    【关键词】 后囊膜下白内障;非超声乳化小切口手术;超声乳化吸除术

    DOI:10.14163/j.cnki.11-5547/r.2017.12.015

    【Abstract】 Objective To compare the effect of non-phaco extraction with small incision and phacoemulsification in the treatment of posterior subcapsular cataract. Methods A total of 80 posterior subcapsular cataract patients were randomlyl divided into control group and research group, with 40 cases in each group. The control group received non-phaco extraction with small incision for treatment, and the research group received phacoemulsification for treatment. Comparison were made on surgical complications, postoperative vision and corneal edema in two groups. Results The research group had lower incidence of complications as 10.00% than 37.50% in the control group, and the difference had statistical significance (P<0.05). In postoperative 3 months of follow-up, the research group had 22 cases with operative eye vision recovered to 0.5 above in postoperative 1 week, accounting for 55.00%, which was 13 cases in the control group, accounting for 32.50%. The research group had 35 cases with operative eye vision recovered to 0.5 above in postoperative 3 months, accounting for 87.50%, which was 24 cases in the control group, accounting for 60.00%. The research group had better postoperative vision recovery than the control group, and the difference had statistical significance (P<0.05). The research group had higher proportion of grade 0 corneal edema than the control group in postoperative 1 week and 3 months, and the difference had statistical significance (P<0.05). Conclusion Phacoemulsification is more ideal in the recovery of visual acuity than non-phaco extraction with small incision with less surgical complications and light corneal edema, which sufficiently proves the treatment advantages of phacoemulsification in treating posterior subcapsular cataract.

    【Key words】 Posterior subcapsular cataract; Non-phaco extraction with small incision; Phacoemulsification

    白內障是老年人致盲的主因, 其中后囊膜下白内障是在晶状体后囊膜下浅层皮质出现棕黄色浑浊, 可观察到许多密集的小点, 其中包括结晶样颗粒和小空泡, 类似于锅巴状[1]。后囊膜下白内障的发病原因主要为缺乏维生素和微量元素, 其次是阳光和紫外线的影响, 此外还有缺氧的因素[2]。目前超声乳化吸除术是白内障患者的首选术式, 疗效高, 安全性好[3]。但其与非超声乳化小切口手术的优势比较, 学者们各执一词。通过本次研究, 作者对两种方法的实用性和安全性进行了探讨, 以期为临床研究提供参考。现报告如下。, 百拇医药(张远超 张亦田 郭灿新)
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