中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
2014年
8期
456-460
,共5页
常平骏%丁锡霞%赵云娥%廉恒丽
常平駿%丁錫霞%趙雲娥%廉恆麗
상평준%정석하%조운아%렴항려
超声乳化白内障吸除术%微切口%体层摄影术,光学相干%角膜切口
超聲乳化白內障吸除術%微切口%體層攝影術,光學相榦%角膜切口
초성유화백내장흡제술%미절구%체층섭영술,광학상간%각막절구
Phacoemulsification%Microincision%Tomography,optical coherence%Corneal incision
目的 对比白内障超声乳化术后3.0 mm和2.2 mm透明角膜切口构型及水肿程度的变化.方法 前瞻性随机对照研究.选择Ⅱ至Ⅲ级核年龄相关性白内障患者35例(58眼),采用随机数字表法分为2组,其中3.0 mm组,共30眼,2.2 mm组,共28眼.术后2h,1周,1个月及3个月分别进行前节OCT检查,观测角膜切口厚度以及外切口哆开、内切口哆开、局部后弹力层脱离、切口失对合等4种切口形态特征.采用独立样本t检验、非参数秩和检验以及卡方检验进行数据分析.结果 2组术后不同时期切口水肿程度差异均无统计学意义,切口水肿在术后3个月才基本消退.术后2h2组外切口哆开、内切口哆开、局部后弹力层脱离以及切口失对合发生率的差异均无统计学意义;术后1周3.0 mm组较2.2 mm组在内切口哆开发生率上较高,两者差异有统计学意义(3.0 mm组23％,2.2 mm组4％,x2=5.192,P＜0.05);术后3个月2组的各种角膜切口形态均愈合.结论 对于Ⅱ至Ⅲ级核的白内障而言,微切口较传统小切口在角膜切口形态恢复时间上可能更短.
目的 對比白內障超聲乳化術後3.0 mm和2.2 mm透明角膜切口構型及水腫程度的變化.方法 前瞻性隨機對照研究.選擇Ⅱ至Ⅲ級覈年齡相關性白內障患者35例(58眼),採用隨機數字錶法分為2組,其中3.0 mm組,共30眼,2.2 mm組,共28眼.術後2h,1週,1箇月及3箇月分彆進行前節OCT檢查,觀測角膜切口厚度以及外切口哆開、內切口哆開、跼部後彈力層脫離、切口失對閤等4種切口形態特徵.採用獨立樣本t檢驗、非參數秩和檢驗以及卡方檢驗進行數據分析.結果 2組術後不同時期切口水腫程度差異均無統計學意義,切口水腫在術後3箇月纔基本消退.術後2h2組外切口哆開、內切口哆開、跼部後彈力層脫離以及切口失對閤髮生率的差異均無統計學意義;術後1週3.0 mm組較2.2 mm組在內切口哆開髮生率上較高,兩者差異有統計學意義(3.0 mm組23％,2.2 mm組4％,x2=5.192,P＜0.05);術後3箇月2組的各種角膜切口形態均愈閤.結論 對于Ⅱ至Ⅲ級覈的白內障而言,微切口較傳統小切口在角膜切口形態恢複時間上可能更短.
목적 대비백내장초성유화술후3.0 mm화2.2 mm투명각막절구구형급수종정도적변화.방법 전첨성수궤대조연구.선택Ⅱ지Ⅲ급핵년령상관성백내장환자35례(58안),채용수궤수자표법분위2조,기중3.0 mm조,공30안,2.2 mm조,공28안.술후2h,1주,1개월급3개월분별진행전절OCT검사,관측각막절구후도이급외절구치개、내절구치개、국부후탄력층탈리、절구실대합등4충절구형태특정.채용독립양본t검험、비삼수질화검험이급잡방검험진행수거분석.결과 2조술후불동시기절구수종정도차이균무통계학의의,절구수종재술후3개월재기본소퇴.술후2h2조외절구치개、내절구치개、국부후탄력층탈리이급절구실대합발생솔적차이균무통계학의의;술후1주3.0 mm조교2.2 mm조재내절구치개발생솔상교고,량자차이유통계학의의(3.0 mm조23％,2.2 mm조4％,x2=5.192,P＜0.05);술후3개월2조적각충각막절구형태균유합.결론 대우Ⅱ지Ⅲ급핵적백내장이언,미절구교전통소절구재각막절구형태회복시간상가능경단.
Objective To compare the architecture and wound edema degree changes of clear-corneal 3.0 mm incisions and 2.2 mm incisions after cataract removal.Methods It was a prospective randomized controlled study.Fifty-eight eyes of 35 age related cataract patients were included and the density of all the cataracts varied from grade Ⅱ to Ⅲ (Emery-Little's classification).Patients were randomized to have phacoemulsification through a small-incision (3.0 mm,n=30) or clear corneal microincision (2.2 mm,n=28) by random digital table.Anterior segment optical coherence tomography evaluation was performed at 2 hours,1 week,1 month and 3 months after surgery.Incisional corneal thickness and wound architecture,including epithelial gaping,endothelial gaping,local detachment of Descemet's membrane and loss of coaptation,were assessed.Independent sample t test,nonparametric Wilcoxon rank-sum test and Chi-square test were used for data analysis.Results There was no statistically significant difference in incisional corneal edema degree between 2 groups at all time points.At 2 hours after the surgery,the difference between 2 groups in the occurrence of epithelial gaping,endothelial gaping,local detachment of Descemet's membrane and loss of coaptation was not statistically significant.At 1 week postoperatively,the incidence of epithelial gaping was higher in the 3.0 mm group than 2.2 mm group and the statistical difference was significant (23％ vs 4％,x2=5.192,P＜0.05).All different morphological incisions in both group recovered at 3 months postoperatively.Conclusion Compared to the traditional small-incisions,the wound morphological characteristics of microincisions might recover faster in the cataracts varying from grade Ⅱ to Ⅲ.
