中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2008年
6期
525-528
,共4页
姚克%汤霞靖%黄晓丹%叶盼盼
姚剋%湯霞靖%黃曉丹%葉盼盼
요극%탕하정%황효단%협반반
白内障%超声乳化白内障吸除术%晶体,人工%治疗结果
白內障%超聲乳化白內障吸除術%晶體,人工%治療結果
백내장%초성유화백내장흡제술%정체,인공%치료결과
Cataract%Phacoemulsifieation%Lenses,intraocular%Treatment outcome
目的 比较双手法微切口超声乳化白内障吸除联合人工晶状体植入术与常规同轴小切口超卢乳化白内障吸除联合人工品状体植入手术的临床效果.方法 采用前瞻性随机对照研究,将280例(280只眼)白内障患者采用随机数字表法分为两组,分别行双手法微切口超卢乳化白内障吸除联合人工晶状体植入术(微切口组,146只眼)和常规小切门超声乳化白内障吸除联合人工晶状体植入术(小切口组,134只眼).分别记录两组超声乳化所用的超声乳化时间和平均功率,计算绝对超卢乳化时间(绝对超声乳化时间=超声乳化时间×平均功率),检查患者术后1 d和3个月的视力、角膜厚度、角膜内皮细胞计数及房水闪光值,以矢量法计算两组患者术后3个月的手术源性散光,并观察手术并发症.采用两均数t检验和χ2检验分别对计量资料和计数资料进行统计学分析.结果 微切口组的超卢乳化时间、平均功率以及绝对超声乳化时间分别为(0.76±0.36)min、10.93%±4.78%及(8.99±7.23)min,均明显低于小切口组(F=4.649,30.072,21.837;P＜0.05).术后3个月,微切口组的手术源性散光[(0.37±0.32)D]显著低于小切口组[(1.28±0.77)D],两组比较差异有统计学意义(F=68.331,P=0.000).两组术后1 d和3个月的视力、房水闪光值、角膜内皮丢失率和角膜增厚程度的差异均无统计学意义(P＞0.05).结论 双手法微切口超声乳化白内障吸除术可以降低超声能量释放,提高乳化效率,并可减少手术源性散光,提高手术疗效;但与传统同轴小切口超声乳化白内障吸除术相比,并未能进一步减少眼内组织损伤和炎性反应.
目的 比較雙手法微切口超聲乳化白內障吸除聯閤人工晶狀體植入術與常規同軸小切口超盧乳化白內障吸除聯閤人工品狀體植入手術的臨床效果.方法 採用前瞻性隨機對照研究,將280例(280隻眼)白內障患者採用隨機數字錶法分為兩組,分彆行雙手法微切口超盧乳化白內障吸除聯閤人工晶狀體植入術(微切口組,146隻眼)和常規小切門超聲乳化白內障吸除聯閤人工晶狀體植入術(小切口組,134隻眼).分彆記錄兩組超聲乳化所用的超聲乳化時間和平均功率,計算絕對超盧乳化時間(絕對超聲乳化時間=超聲乳化時間×平均功率),檢查患者術後1 d和3箇月的視力、角膜厚度、角膜內皮細胞計數及房水閃光值,以矢量法計算兩組患者術後3箇月的手術源性散光,併觀察手術併髮癥.採用兩均數t檢驗和χ2檢驗分彆對計量資料和計數資料進行統計學分析.結果 微切口組的超盧乳化時間、平均功率以及絕對超聲乳化時間分彆為(0.76±0.36)min、10.93%±4.78%及(8.99±7.23)min,均明顯低于小切口組(F=4.649,30.072,21.837;P＜0.05).術後3箇月,微切口組的手術源性散光[(0.37±0.32)D]顯著低于小切口組[(1.28±0.77)D],兩組比較差異有統計學意義(F=68.331,P=0.000).兩組術後1 d和3箇月的視力、房水閃光值、角膜內皮丟失率和角膜增厚程度的差異均無統計學意義(P＞0.05).結論 雙手法微切口超聲乳化白內障吸除術可以降低超聲能量釋放,提高乳化效率,併可減少手術源性散光,提高手術療效;但與傳統同軸小切口超聲乳化白內障吸除術相比,併未能進一步減少眼內組織損傷和炎性反應.
목적 비교쌍수법미절구초성유화백내장흡제연합인공정상체식입술여상규동축소절구초로유화백내장흡제연합인공품상체식입수술적림상효과.방법 채용전첨성수궤대조연구,장280례(280지안)백내장환자채용수궤수자표법분위량조,분별행쌍수법미절구초로유화백내장흡제연합인공정상체식입술(미절구조,146지안)화상규소절문초성유화백내장흡제연합인공정상체식입술(소절구조,134지안).분별기록량조초성유화소용적초성유화시간화평균공솔,계산절대초로유화시간(절대초성유화시간=초성유화시간×평균공솔),검사환자술후1 d화3개월적시력、각막후도、각막내피세포계수급방수섬광치,이시량법계산량조환자술후3개월적수술원성산광,병관찰수술병발증.채용량균수t검험화χ2검험분별대계량자료화계수자료진행통계학분석.결과 미절구조적초로유화시간、평균공솔이급절대초성유화시간분별위(0.76±0.36)min、10.93%±4.78%급(8.99±7.23)min,균명현저우소절구조(F=4.649,30.072,21.837;P＜0.05).술후3개월,미절구조적수술원성산광[(0.37±0.32)D]현저저우소절구조[(1.28±0.77)D],량조비교차이유통계학의의(F=68.331,P=0.000).량조술후1 d화3개월적시력、방수섬광치、각막내피주실솔화각막증후정도적차이균무통계학의의(P＞0.05).결론 쌍수법미절구초성유화백내장흡제술가이강저초성능량석방,제고유화효솔,병가감소수술원성산광,제고수술료효;단여전통동축소절구초성유화백내장흡제술상비,병미능진일보감소안내조직손상화염성반응.
Objective To compare the outcomes of bimanual microincision phacoemulsification with conventional small incision cataract surgery. Methods A randomized prospective study of 280 consecutive cases (280 eyes) was conducted. All patients were randomly assigned to receive bimanual microincision cataract surgery (MICS group) or small incision cataract surgery (SICS group). The PHACO time (PT) and the average power (AP) were recorded, then absolute PHACO time ( APT = PT x AP) was calculated.The differences in PT, AP, APT and BCVA between these two groups were compared. Visual acuity,anterior chamber flare value, thickened pachymetry and endothelial cells loss were recorded 1 day and 3 months after surgery. In addition, surgically induced astigmatism was analyzed. Results The mean PT, AP and APT of MICS group were significantly lower than those in the SICS group (0.76 ±0.36) rain versus (0.87 ± 0.49)rain, 10.93% ± 4.78% versus 16.09% ± 7.38% and (8.99 ± 7.23 ) rain versus ( 15.27 ±12.10)min, respectively (P < 0.01 ). At 3 months, the vertical astigmatic changes of MICS group was statistically lower than that of the SICS group [ ( 0.37 ± 0.32 ) D versus ( 1.28 ± 0.77 ) D, P = 0.000 ].There were no significant differences in the visual acuity, anterior chamber flare value, endothelial cells loss and the thickened pachymetry at 1 day and 3 months after surgery between these two groups ( P > 0.05 ).Conclusions Bimanual microincision cataract surgery could significantly reduce PHACO power, enhance energy efficiency and reduce surgically induced astigmatism. However, MICS does not reduce surgical trauma and postoperative inflammation as compared to conventional SICS.
