中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2011年
10期
903-907
,共5页
超声乳化白内障吸除术%白内障%外科手术,微创性%治疗结果
超聲乳化白內障吸除術%白內障%外科手術,微創性%治療結果
초성유화백내장흡제술%백내장%외과수술,미창성%치료결과
Phacoemulsification%Cataract%Surgical procedures,minimally invasive%Treatment outcome
目的 观察同轴1.8mm微切口超声乳化白内障手术的临床效果,并与传统同轴3.0mm小切口超声乳化手术进行比较.方法 前瞻性随机对照研究.采用随机数字表法,将实施超声乳化白内障手术的年龄相关性白内障患者89例(89只眼)随机分为2组.微切口组:同轴1.8mm微切口超声乳化白内障吸除联合人工晶状体植入手术45例(45只眼)；小切口组:传统同轴3.0mm小切口超声乳化白内障吸除联合人工晶状体植入术44例(44只眼).取随访资料完整者,微切口组40例(40只眼),小切口组40例(40只眼)进行分析.分别记录两组超声乳化所用的平均超声能量(AVE)和有效超声时间(EPT),术后1d、1周、1个月和3个月随访,检查并记录视力、角膜内皮密度、中央角膜厚度,手术源性散光.采用两均数t检验和x2检验对数据进行统计学分析.结果 两组所用EPT和AVE差异无统计学意义(t=-0.149,P=0.882；t=-0.769,P=0.444).术后1d,微切口组裸眼LogMAR视力0.16±0.14优于小切口组0.23±0.12,且差异具有统计学意义(t=-2.371,P=0.020).术后1周、1个月和3个月,两组矫正视力差异均无统计学意义(t=-1.469,-1.437,-1.585；P=0.146,0.155,0.117).术后1d、1周、1个月和3个月,两组角膜内皮细胞密度及中央角膜增厚程度改变差异无统计学意义(P＞0.05).术后1d、1周、1个月及3个月,同轴微切口组手术源性散光分别为(0.62±0.28)D,(0.48±0.28)D,(0.47±0.25)D,(0.40±0.24)D；同轴小切口组手术源性散光分别为(1.27±0.65)D,(1.18±0.59)D,(1.02±0.56)D,(0.79±0.48)D,两组间差异具有统计学意义(t=-5.940,-7.247,-5.779,-4.788;P =0.000,0.000,0.000,0.000).微切口组手术源性散光于1周后明显下降(t=2.517,P=0.014)并趋于稳定,小切口组手术源性散光则于术后1个月出现明显下降(t =2.105,P=0.038).结论 同轴1.8mm微切口与传统的同轴3.0mm小切口超声乳化白内障手术相比,能有效减少手术源性散光,且散光状态更早稳定,对术后视力早期恢复具有优势.
目的 觀察同軸1.8mm微切口超聲乳化白內障手術的臨床效果,併與傳統同軸3.0mm小切口超聲乳化手術進行比較.方法 前瞻性隨機對照研究.採用隨機數字錶法,將實施超聲乳化白內障手術的年齡相關性白內障患者89例(89隻眼)隨機分為2組.微切口組:同軸1.8mm微切口超聲乳化白內障吸除聯閤人工晶狀體植入手術45例(45隻眼)；小切口組:傳統同軸3.0mm小切口超聲乳化白內障吸除聯閤人工晶狀體植入術44例(44隻眼).取隨訪資料完整者,微切口組40例(40隻眼),小切口組40例(40隻眼)進行分析.分彆記錄兩組超聲乳化所用的平均超聲能量(AVE)和有效超聲時間(EPT),術後1d、1週、1箇月和3箇月隨訪,檢查併記錄視力、角膜內皮密度、中央角膜厚度,手術源性散光.採用兩均數t檢驗和x2檢驗對數據進行統計學分析.結果 兩組所用EPT和AVE差異無統計學意義(t=-0.149,P=0.882；t=-0.769,P=0.444).術後1d,微切口組裸眼LogMAR視力0.16±0.14優于小切口組0.23±0.12,且差異具有統計學意義(t=-2.371,P=0.020).術後1週、1箇月和3箇月,兩組矯正視力差異均無統計學意義(t=-1.469,-1.437,-1.585；P=0.146,0.155,0.117).術後1d、1週、1箇月和3箇月,兩組角膜內皮細胞密度及中央角膜增厚程度改變差異無統計學意義(P＞0.05).術後1d、1週、1箇月及3箇月,同軸微切口組手術源性散光分彆為(0.62±0.28)D,(0.48±0.28)D,(0.47±0.25)D,(0.40±0.24)D；同軸小切口組手術源性散光分彆為(1.27±0.65)D,(1.18±0.59)D,(1.02±0.56)D,(0.79±0.48)D,兩組間差異具有統計學意義(t=-5.940,-7.247,-5.779,-4.788;P =0.000,0.000,0.000,0.000).微切口組手術源性散光于1週後明顯下降(t=2.517,P=0.014)併趨于穩定,小切口組手術源性散光則于術後1箇月齣現明顯下降(t =2.105,P=0.038).結論 同軸1.8mm微切口與傳統的同軸3.0mm小切口超聲乳化白內障手術相比,能有效減少手術源性散光,且散光狀態更早穩定,對術後視力早期恢複具有優勢.
목적 관찰동축1.8mm미절구초성유화백내장수술적림상효과,병여전통동축3.0mm소절구초성유화수술진행비교.방법 전첨성수궤대조연구.채용수궤수자표법,장실시초성유화백내장수술적년령상관성백내장환자89례(89지안)수궤분위2조.미절구조:동축1.8mm미절구초성유화백내장흡제연합인공정상체식입수술45례(45지안)；소절구조:전통동축3.0mm소절구초성유화백내장흡제연합인공정상체식입술44례(44지안).취수방자료완정자,미절구조40례(40지안),소절구조40례(40지안)진행분석.분별기록량조초성유화소용적평균초성능량(AVE)화유효초성시간(EPT),술후1d、1주、1개월화3개월수방,검사병기록시력、각막내피밀도、중앙각막후도,수술원성산광.채용량균수t검험화x2검험대수거진행통계학분석.결과 량조소용EPT화AVE차이무통계학의의(t=-0.149,P=0.882；t=-0.769,P=0.444).술후1d,미절구조라안LogMAR시력0.16±0.14우우소절구조0.23±0.12,차차이구유통계학의의(t=-2.371,P=0.020).술후1주、1개월화3개월,량조교정시력차이균무통계학의의(t=-1.469,-1.437,-1.585；P=0.146,0.155,0.117).술후1d、1주、1개월화3개월,량조각막내피세포밀도급중앙각막증후정도개변차이무통계학의의(P＞0.05).술후1d、1주、1개월급3개월,동축미절구조수술원성산광분별위(0.62±0.28)D,(0.48±0.28)D,(0.47±0.25)D,(0.40±0.24)D；동축소절구조수술원성산광분별위(1.27±0.65)D,(1.18±0.59)D,(1.02±0.56)D,(0.79±0.48)D,량조간차이구유통계학의의(t=-5.940,-7.247,-5.779,-4.788;P =0.000,0.000,0.000,0.000).미절구조수술원성산광우1주후명현하강(t=2.517,P=0.014)병추우은정,소절구조수술원성산광칙우술후1개월출현명현하강(t =2.105,P=0.038).결론 동축1.8mm미절구여전통적동축3.0mm소절구초성유화백내장수술상비,능유효감소수술원성산광,차산광상태경조은정,대술후시력조기회복구유우세.
Objective To study and compare the outcomes of coaxial 1.8 mm microincision phacoemulsiflcation with conventional coaxial 3 mm small-incision cataract surgery.Methods A randomized prospective study was conducted on 89 patients with age-related cataract:coaxial 1.8 mm microincision cataract surgery ( MICS group) was performed in 45 cases (45 eyes),and coaxial 3 mm small incision cataract surgery (SICS group) was performed in 44 cases (44 eyes).Statistical analysis was taken with the data of 40 cases (40 eyes) in the MICS group and 40 cases (40 eyes) in the SICS group.The average ultrasound power (AVE) and effective phacoemulsification time (EPT) were recorded during the operation.Visual acuity,endothelial cell density and cornea thickness were compared at intervals of 1 day,1 week,1 month and 3 months after surgerf.In addition,surgically induced astigmatism (SIA) was analyzed.Statistic analysis was taken by student's t test and chi square test.Results There was no significant difference on AVE and EPT (P ＞ 0.05 ) between these two groups.One day after the surgery,the MICS group showed better uncorrected visual acuity (0.16 ±0.14) as compared to the SICS group (0.23± 0.12).The difference was statistically significant ( P ＜ 0.05 ).There were no significant differences on best corrected visual acuity,endothelial cell density and cornea thickness between these two groups.One week,1 month and 3 months after the surgery,SIA was (0.62 ± 0.28) D,(0.48 ± 0.28) D,(0.47 ±0.25) D,(0.40 ± 0.24) DintheMICSgroup,and(1.27 ± 0.65) D,(1.18 ± 0.59) D,(1.02 ±0.56) D,(0.79 ± 0.48) D in the SICS group,respectively.The differences between the MIC and SICS groups were statistically significant (P ＜0.01 ).SIA decreased significantly and became stable 1 week after surgery in MICS group,while the similar tendency appeared one month after the surgery in the SICS group.Conclusions Coaxial 1.8 mm microincision cataract surgery could significantly reduce SIA and obtain more stable astigmatism status.This suggests that the coaxial MICS phacoemulsification surgery could get earlier visual rehabilitation postoperatively.
