CAJ | 학술논문

目的对比2.2mm同轴微切口白内障超声乳化手术与 3.0mm标准切口同轴超声乳化手术的早期临床效果.方法 2011年6月至2011年11月行白内障超声乳化吸除联合人工晶体植入术的老年性白内障患者70例(70眼),随机分为2组:2.2 mm组35例(35眼),3.0 mm组35例(35眼),分别通过2.2 mm微切口及3.0mm标准透明角膜切口行同轴超声乳化白内障吸除联合人工晶状体植入术(Alcon公司 Infiniti),植入Alcon公司SN60WF人工晶状体.对比两种手术方式的术后早期视力,中央及切口部位角膜内皮细胞密度,角膜厚度,切口部位形态(内切口哆开、角膜后弹力层脱离),角膜水肿的影响.结果裸眼视力两组术后第1天差异无统计学意义(P=0.307),矫正视力术后1周及1月差异无统计学意义(P =0.816,0.911).中央角膜内皮细胞密度术后第1天,两组较术前均有明显下降,2.2 mm组P=0.002,3.0 mm组P=0.001,但两组间比较,中央角膜内皮细胞密度减少率的差异无统计学意义(P=0.456);角膜切口内皮细胞密度减少率差异无统计学意义(P=0.820).中央角膜厚度两组术后第1天增厚程度差异无统计学意义(P=0.821).角膜切口厚度两组术后第1天,第1周及第2周时,与术前比较,差异均有统计学意义,但第3周时,2.2 mm组差异无统计学意义(P=0.159),而3.0mm组,至1个月时,差异才无统计学意义(P=0.278).角膜水肿率两组术后第1天,差异无统计学意义(P=0.307).2.2mm同轴微切口组术后第1天内切口哆开率低于3.0mm组,P=0.040,同时内切口后弹力层脱离率低于3.0mm组,P=0.023.结论 2.2mm同轴微切口超声乳化手术与3.0 mm标准切口超声乳化手术相比,对角膜形态影响小,并发症发生机率减小,术后角膜切口愈合时间缩短,术后角膜伤口恢复更快.
목적 대비2.2mm동축미절구백내장초성유화수술여 3.0mm표준절구동축초성유화수술적조기림상효과.방법 2011년6월지2011년11월행백내장초성유화흡제연합인공정체식입술적노년성백내장환자70례(70안),수궤분위2조:2.2 mm조35례(35안),3.0 mm조35례(35안),분별통과2.2 mm미절구급3.0mm표준투명각막절구행동축초성유화백내장흡제연합인공정상체식입술(Alcon공사 Infiniti),식입Alcon공사SN60WF인공정상체.대비량충수술방식적술후조기시력,중앙급절구부위각막내피세포밀도,각막후도,절구부위형태(내절구치개、각막후탄력층탈리),각막수종적영향.결과 라안시력량조술후제1천차이무통계학의의(P=0.307),교정시력술후1주급1월차이무통계학의의(P =0.816,0.911).중앙각막내피세포밀도술후제1천,량조교술전균유명현하강,2.2 mm조P=0.002,3.0 mm조P=0.001,단량조간비교,중앙각막내피세포밀도감소솔적차이무통계학의의(P=0.456);각막절구내피세포밀도감소솔차이무통계학의의(P=0.820).중앙각막후도량조술후제1천증후정도차이무통계학의의(P=0.821).각막절구후도량조술후제1천,제1주급제2주시,여술전비교,차이균유통계학의의,단제3주시,2.2 mm조차이무통계학의의(P=0.159),이3.0mm조,지1개월시,차이재무통계학의의(P=0.278).각막수종솔량조술후제1천,차이무통계학의의(P=0.307).2.2mm동축미절구조술후제1천내절구치개솔저우3.0mm조,P=0.040,동시내절구후탄력층탈리솔저우3.0mm조,P=0.023.결론 2.2mm동축미절구초성유화수술여3.0 mm표준절구초성유화수술상비,대각막형태영향소,병발증발생궤솔감소,술후각막절구유합시간축단,술후각막상구회복경쾌.
Objective To compare the outcomes of coaxial 2.2mm microincision phacoemulsification with standard coaxial 3.0mm clear corneal incision cataract surgery.Methods In this prospective randomized study,35 patients (35 eyes) had 2.2mm microincision phacoemulsification and 35 patients (35 eyes) had 3.0mm standard coaxial phacoemulsification.Torsional mode of the Infiniti Vision System was applied for the surgery.Visual acuity,endothelial cell density,cornea thickness and wound architecture were compared at intervals of 1 day,1 week,2 weeks,3weeks and 1 month after surgery.Results There was no significant difference on visual acuity between these two groups.There were no statistically differences in the lost rate of central/ wound area corneal endothelial cell density between two groups 1 day postoperatively.No statistically difference in central corneal thickness was found between the groups 1 day postoperatively.All incisions had slight corneal edema limited to the incision area in the two groups.The increasing rate of the thickness of incision has the statistical difference 1 day,1 week,2 weeks postoperatively in both groups.There was no statistically difference in 2.2mm group (P=0.159),but there was statistically difference in 3.0mm group (P =0.009) at 3 weeks postoperativcly.There was no statistically difference in 3.0mm group until 1 month postoperatively.At 1 day the wound gape rate was lower in the 2.2mm group (P =0.040)and the Descemet membrane detachment rate was also lower in 2.2mm group (P=0.023).Conclusions Compared to standard coaxial 3.0mm clear corneal incision cataract surgery,coaxial 2.2mm microincision phacoemulsification had slightly fewer undesirable effects on the incision site.The 2.2mm microincision phacoemulsification could get earlier cornea rehabilitation postoperatively.Financial Disclosure:No author has a financial or proprietary interest in any material or method mentioned.