CAJ | 학술논문

目的：对比分析小切口超声乳化和非超声乳化白内障摘除术的临床效果。 　　方法：选取白内障患者172例,以随机数字法分为两组(n=86)；Phaco组采用小切口超声乳化白内障吸除和人工晶状体植入术,Siecs组采用小切口非超声乳化白内障摘除和人工晶状体植入术；并分别于术后3d；1,6mo和末次随访进行功能测定,对比组间视力、眼内压、前房深度、平均角膜曲率(averagecornealpower,ACP)、角膜表面散光值(cylinder,CYL)和角膜表面不对称指数(surfaceasymmetryindex,SAI)及手术并发症。 　　结果：术后3d,Phaco组视力情况显著优于Siecs组(P<0-05),CYL、SAI和眼内压显著低于Siecs组(P<0.05)；术后1mo,Phaco组视力情况显著优于Siecs组(P<0.05),CYL,SAI和眼内压稍低于Siecs组,但无组间差异(P>0-05)；术后6mo,Phaco组视力情况依然稍优于Siecs组,但无组间差异(P>0.05),CYL,SAI和眼内压与Siecs组持平(P>0.05)；此外,两组患者的ACP与前房深度各时间点测定值无组间差异(P>0.05)。在术后并发症方面,两组患者的总发生率相仿(P>0.05)；但有个体差异,Phaco组Ⅱ,Ⅲ级核患者的发生率显著低于Siecs组(P<0-05),Ⅳ级核患者的发生率显著高于Siecs组(P<0.05)。 　　结论：超声乳化白内障摘除术治疗Ⅱ,Ⅲ级核白内障患者可获得更好的疗效,但对于Ⅳ级核病变患者并发症风险较高,可考虑小切口非超声乳化白内障摘除术。
목적：대비분석소절구초성유화화비초성유화백내장적제술적림상효과。 　　방법：선취백내장환자172례,이수궤수자법분위량조(n=86)；Phaco조채용소절구초성유화백내장흡제화인공정상체식입술,Siecs조채용소절구비초성유화백내장적제화인공정상체식입술；병분별우술후3d；1,6mo화말차수방진행공능측정,대비조간시력、안내압、전방심도、평균각막곡솔(averagecornealpower,ACP)、각막표면산광치(cylinder,CYL)화각막표면불대칭지수(surfaceasymmetryindex,SAI)급수술병발증。 　　결과：술후3d,Phaco조시력정황현저우우Siecs조(P<0-05),CYL、SAI화안내압현저저우Siecs조(P<0.05)；술후1mo,Phaco조시력정황현저우우Siecs조(P<0.05),CYL,SAI화안내압초저우Siecs조,단무조간차이(P>0-05)；술후6mo,Phaco조시력정황의연초우우Siecs조,단무조간차이(P>0.05),CYL,SAI화안내압여Siecs조지평(P>0.05)；차외,량조환자적ACP여전방심도각시간점측정치무조간차이(P>0.05)。재술후병발증방면,량조환자적총발생솔상방(P>0.05)；단유개체차이,Phaco조Ⅱ,Ⅲ급핵환자적발생솔현저저우Siecs조(P<0-05),Ⅳ급핵환자적발생솔현저고우Siecs조(P<0.05)。 　　결론：초성유화백내장적제술치료Ⅱ,Ⅲ급핵백내장환자가획득경호적료효,단대우Ⅳ급핵병변환자병발증풍험교고,가고필소절구비초성유화백내장적제술。
AIM: To contrast the effect of small incision phacoemulsification and non-phacoemulsification to treat cataract. METHODS: Totally 172 patients with cataract were divided into 2 groups ( n = 86 ) randomly. Patients in Group Phaco were treated with phacoemulsification and, while those in Group Siecs were treated with small incision extracapsular cataract surgery and intraocular lens implantation. They were all followed up for 1-3y. Functional examinations were made at 3d;1,6mo and last follow - up. The visual acuity, intraocular pressure, anterior chamber depth, average corneal power ( ACP ) , cylinder ( CYL ) , surface asymmetry index ( SAI ) and complications were contrasted between groups. RESULTS: At 3d after operation, the visual acuity of Group Phaco was better than that of Group Siecs ( P<0-05), and CYL, SAI and intraocular pressure of Group Phaco were all significantly lower than those of Group Siecs (P<0. 05). At 1mo after operation, the visual acuity of Group Phaco was better than that of Group Siecs ( P<0-05), and CYL, SAI and intraocular pressure of Group Phaco were slightly lower than those of Group Siecs ( P<0. 05);there was no difference between the two group. At 6mo after operation, the visual acuity of Group Phaco was still better than that of Group Siecs (P<0. 05), and CYL, SAI and intraocular pressure of Group Phaco were flat as those of Group Siecs (P<0. 05); there was no difference between groups in those indexes above ( P > 0. 05 ). Furthermore, the APC and anterior chamber depth of each point- in - time had no significant difference between groups (P>0. 05). The incidences of complication were similar in two groups ( P> 0. 05 ); but with individual differences, patients of GradeII and Ⅲ in Group Phaco got lower complication rate (P<0. 05), while those of Grade Ⅳ higher (P<0. 05) than those of Group Siecs. CONCLUSION: Our research shows that phacoemulsification has high effect in the treatment of patients with GradeII and Ⅲ nuclear hardness, while small incision extracapsular cataract surgery has high effect in the treatment of patients with Grade Ⅳ nuclear hardness.