中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2009年
12期
1414-1416
,共3页
付海涛%宋磊%唐正香%沈泽民
付海濤%宋磊%唐正香%瀋澤民
부해도%송뢰%당정향%침택민
白内障%超声乳化白内障吸除术%人工晶状体
白內障%超聲乳化白內障吸除術%人工晶狀體
백내장%초성유화백내장흡제술%인공정상체
Cataract%Phacoemulsifieation%IOL
目的 探讨Ⅳ级以上硬核白内障的最佳手术方式.方法 选择Ⅳ级以上硬核白内障患者113例113只眼随机分为whitestar组、STORZ组和改良ECCE组,分别进行冷超声乳化白内障摘出术(38只眼)、普通超声乳化白内障摘出术(38只眼)和改良白内障囊外摘除术(37只眼),均联合人工晶状体植入术,对手术时的核处理时间、术中并发症、术后炎症反应、角膜内皮细胞丢失率及术后视力进行对比观察.结果 whitestar组、STORZ组和改良ECCE组手术时间分别(13.14±4.15)min、(16.14±5.25)min、(11.85±3.24)min,P<0.001;术后并发症及术后炎症反应以STORZ组最明显(P<0.05);术后1周内皮细胞丢失率,普通超生乳化组(15.12%)明显高于改良ECCE组(6.72%)(P<0.05);术后视力早期差别明显(P<0.005).结论 改良ECCE具有安全、视力恢复快、并发症少的特点,是治疗Ⅳ级以上硬核白内障较理想的选择.
目的 探討Ⅳ級以上硬覈白內障的最佳手術方式.方法 選擇Ⅳ級以上硬覈白內障患者113例113隻眼隨機分為whitestar組、STORZ組和改良ECCE組,分彆進行冷超聲乳化白內障摘齣術(38隻眼)、普通超聲乳化白內障摘齣術(38隻眼)和改良白內障囊外摘除術(37隻眼),均聯閤人工晶狀體植入術,對手術時的覈處理時間、術中併髮癥、術後炎癥反應、角膜內皮細胞丟失率及術後視力進行對比觀察.結果 whitestar組、STORZ組和改良ECCE組手術時間分彆(13.14±4.15)min、(16.14±5.25)min、(11.85±3.24)min,P<0.001;術後併髮癥及術後炎癥反應以STORZ組最明顯(P<0.05);術後1週內皮細胞丟失率,普通超生乳化組(15.12%)明顯高于改良ECCE組(6.72%)(P<0.05);術後視力早期差彆明顯(P<0.005).結論 改良ECCE具有安全、視力恢複快、併髮癥少的特點,是治療Ⅳ級以上硬覈白內障較理想的選擇.
목적 탐토Ⅳ급이상경핵백내장적최가수술방식.방법 선택Ⅳ급이상경핵백내장환자113례113지안수궤분위whitestar조、STORZ조화개량ECCE조,분별진행랭초성유화백내장적출술(38지안)、보통초성유화백내장적출술(38지안)화개량백내장낭외적제술(37지안),균연합인공정상체식입술,대수술시적핵처리시간、술중병발증、술후염증반응、각막내피세포주실솔급술후시력진행대비관찰.결과 whitestar조、STORZ조화개량ECCE조수술시간분별(13.14±4.15)min、(16.14±5.25)min、(11.85±3.24)min,P<0.001;술후병발증급술후염증반응이STORZ조최명현(P<0.05);술후1주내피세포주실솔,보통초생유화조(15.12%)명현고우개량ECCE조(6.72%)(P<0.05);술후시력조기차별명현(P<0.005).결론 개량ECCE구유안전、시력회복쾌、병발증소적특점,시치료Ⅳ급이상경핵백내장교이상적선택.
Objective To explore the optimal operation method of the cataract with above IV grade hard nucleus.Methods The surgeries were performed on eyes of 113 patients with senile cataract above IV grade nucleus and the cases were randomly divided into three groups,the cold phacoemulsification group (Whitestar group,38 eyes),the general phacoemulsification group(STORZ group,38eyes),and the improved extra-capsular cataract extraction group(improved ECCE group,37 eyes).The improved extra-capsular cataract extraction through sclera tunnel sutureless incision and tWO types phacoemulsification with PMMA intraocular lens implantation were performed respectively.The surgical time,operative complications,postoperative inflammation,corneal endothelial cells and visual acuity were obtained after surgery.Results The surgical time of Whitestar group,STORZ group and improved ECCE group was 13.14±4.15min,16.14±5.25min,11.85±3.24min respectively(P＜0.001).Postoperative complications and inflammation of the STORZ group was the most obvious(P＜0.05).The rate of the losing of corneal endothelial cells in the general phacoemulsification group(15.12%)was larger than that in the improved ECCE group(6.72%)significantly.The difference of postoperative visual acuity was obvious in early stage.Conclusions The improved extra capsular cataract extraction has many virtues of security,faster visual recovery,and less complications.It is the ideal choice for treatment of cataract with above IV grade hard nucleus.
