中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
CHINESE JOURNAL OF OCULAR TRAUMA AND OCCUPATIONAL EYE DISEASE
2014年
6期
409-412
,共4页
谭青青%廖萱%兰长骏%董兴堂
譚青青%廖萱%蘭長駿%董興堂
담청청%료훤%란장준%동흥당
白内障%超声乳化术%切口,2.2 mm,2.75 mm%角膜内皮细胞%超声能量
白內障%超聲乳化術%切口,2.2 mm,2.75 mm%角膜內皮細胞%超聲能量
백내장%초성유화술%절구,2.2 mm,2.75 mm%각막내피세포%초성능량
Cataract%Phacoemulsification%Incision,2.2 mm,2.75 mm%Cell,endothelial,corneal%Energy,ultrasonic
目的 比较2.2mm与2.75 mm同轴透明角膜切口超声乳化术中超声能量水平及术后角膜内皮细胞密度(CED)的变化.方法 前瞻、随机、对照性临床研究,将134例(167只眼)白内障按简单随机分组法分为两组:2.2mm切口组57例(70只眼)和2.75 mm切口组77例(97只眼).记录两组术前晶状体核硬度分级,测量两组术前、术后1个月及3个月的CED,记录术中两组病例的超声乳化时间及平均能量,计算各自的有效超声时间(EPT).比较两组之间及组内各时间点CED差异及两组术中EPT差异.结果 两组晶状体核硬度分级构成比差异无统计学意义,两组术中EPT比较差异无统计学意义(P＞0.05),且均与核硬度分级呈明显正相关.两组术后CED均有所减少,2.2mm组:术前(2510.88 ±268.81)个/mm2,术后3个月(2378.84±369.93)个/mm2 (P＜ 0.05);2.75mm组:术前(2524.62±251.69)个/mm2,术后3个月(2388.08 ±360.51)个/mm2(P＜0.01).两组术后CED均于术后1个月开始稳定,术后3个月与1个月CED比较差异无统计学意义(P＞0.05).两组之间CED变化幅度差异无统计学意义(P＞0.05).结论 与2.75 mm切口组相比,2.2 mm切口组切口变小,手术难度加大,但没有增加术中超声能量,且两组术中所用超声能量水平均与晶状体核硬度分级呈正相关.两组间内皮细胞的丢失量的差异无统计学意义.
目的 比較2.2mm與2.75 mm同軸透明角膜切口超聲乳化術中超聲能量水平及術後角膜內皮細胞密度(CED)的變化.方法 前瞻、隨機、對照性臨床研究,將134例(167隻眼)白內障按簡單隨機分組法分為兩組:2.2mm切口組57例(70隻眼)和2.75 mm切口組77例(97隻眼).記錄兩組術前晶狀體覈硬度分級,測量兩組術前、術後1箇月及3箇月的CED,記錄術中兩組病例的超聲乳化時間及平均能量,計算各自的有效超聲時間(EPT).比較兩組之間及組內各時間點CED差異及兩組術中EPT差異.結果 兩組晶狀體覈硬度分級構成比差異無統計學意義,兩組術中EPT比較差異無統計學意義(P＞0.05),且均與覈硬度分級呈明顯正相關.兩組術後CED均有所減少,2.2mm組:術前(2510.88 ±268.81)箇/mm2,術後3箇月(2378.84±369.93)箇/mm2 (P＜ 0.05);2.75mm組:術前(2524.62±251.69)箇/mm2,術後3箇月(2388.08 ±360.51)箇/mm2(P＜0.01).兩組術後CED均于術後1箇月開始穩定,術後3箇月與1箇月CED比較差異無統計學意義(P＞0.05).兩組之間CED變化幅度差異無統計學意義(P＞0.05).結論 與2.75 mm切口組相比,2.2 mm切口組切口變小,手術難度加大,但沒有增加術中超聲能量,且兩組術中所用超聲能量水平均與晶狀體覈硬度分級呈正相關.兩組間內皮細胞的丟失量的差異無統計學意義.
목적 비교2.2mm여2.75 mm동축투명각막절구초성유화술중초성능량수평급술후각막내피세포밀도(CED)적변화.방법 전첨、수궤、대조성림상연구,장134례(167지안)백내장안간단수궤분조법분위량조:2.2mm절구조57례(70지안)화2.75 mm절구조77례(97지안).기록량조술전정상체핵경도분급,측량량조술전、술후1개월급3개월적CED,기록술중량조병례적초성유화시간급평균능량,계산각자적유효초성시간(EPT).비교량조지간급조내각시간점CED차이급량조술중EPT차이.결과 량조정상체핵경도분급구성비차이무통계학의의,량조술중EPT비교차이무통계학의의(P＞0.05),차균여핵경도분급정명현정상관.량조술후CED균유소감소,2.2mm조:술전(2510.88 ±268.81)개/mm2,술후3개월(2378.84±369.93)개/mm2 (P＜ 0.05);2.75mm조:술전(2524.62±251.69)개/mm2,술후3개월(2388.08 ±360.51)개/mm2(P＜0.01).량조술후CED균우술후1개월개시은정,술후3개월여1개월CED비교차이무통계학의의(P＞0.05).량조지간CED변화폭도차이무통계학의의(P＞0.05).결론 여2.75 mm절구조상비,2.2 mm절구조절구변소,수술난도가대,단몰유증가술중초성능량,차량조술중소용초성능량수평균여정상체핵경도분급정정상관.량조간내피세포적주실량적차이무통계학의의.
Objective To compare the intraoperative ultrasound energy and the change of corneal endothelial cell density (CED) in 2.2 mm or 2.75 mm corneal incision phacoemulsification.Methods A prospective,randomized and controlled clinical study was conducted on 134 patients with 167 cataract eyes which were randomly divided into two groups:2.2 mm group (70 eyes of 57 patients) and 2.75 mm group (97 eyes of 77 patients).The hard degree of the nucleus was recorded.The CED was measured preoperatively,1 month and 3 months postoperatively.It was compared between the two groups.The phaco time and average energy in the surgery were recorded to calculate the effective phaco time (EPT).The intraoperative EPT was compared between the two groups.Results There was no statistically significant difference in nuclear hardness or in EPT between the two groups,but there was a positive correlation between them in both the two groups.Postoperative CED was reduced in 2.2 mm and 2.75 mm group as follows:(2510.88 ±268.81) mm-2 preoperatively and (2378.84 ± 369.93) mm-2 at 3 months postoperatively (P ＜ 0.05) in 2.2 mm group; (2524.62 ± 251.69) mm-2 preoperatively and (2388.08 ± 360.51) mm-2 at 3 months postoperatively (P ＜0.01) in 2.75 mm group.The CED trended to be stabilized 1 month postoperatively.There were no statistically significant difference in the changes of CED between the two groups (P ＞ 0.05).Conclusion Comparing with 2.75 mm incision,2.2 mm coaxial clear corneal incision is shorter in length and thus making more difficulty in the operation.However,intraoperative ultrasound energy has not increased in 2.2 mm incision system.The EPT is correlated with nucleus hardness.There is no statistically significant difference in postoperative CED loss between the two groups.
