CAJ | 학술논문

背景随着超声乳化白内障摘出术的发展和进步,探索在更小切口下安全、有效地摘出混浊晶状体的手术方式,从而减轻术中组织的损伤程度,减少术后并发症的发生率逐渐成为临床关注的焦点. 目的探讨1.8mm同轴微切口超声乳化白内障摘出术的可行性和临床疗效. 方法本研究为系列病例观察研究.纳入2012年4-5月在内蒙古自治区人民医院眼科拟行超声乳化白内障摘出术的单纯年龄相关性白内障患者32例32眼,其中Ⅱ级核者8例8眼,Ⅲ级核者16例16眼,Ⅳ级核者8例8眼.所有患眼行A型超声测量眼轴长度,IOL度数按照SRK-Ⅱ公式计算.对患眼行盐酸丙美卡因滴眼液表面麻醉,于10:00 ～11:00位用专用手术刀行1.8mm隧道式透明角膜切口,于2:00位做侧切口,其他步骤同常规超声乳化白内障摘出术,并通过1.8mm的切口植入Akreos MI60型人工晶状体(IOL).观察术中超声乳化时间、术后视力和手术并发症.结果所有术眼手术顺利.各级核患眼术中平均超声乳化有效时间为(7.0±3.6)s,平均超声能量为(15.3±6.1)％.术后1d、1周及1个月时裸眼视力≥0.5的术眼分别为18、28和30眼,分别占56.25％、87.50％及93.75％;术后1个月最佳矫正视力≥0.5和0.8者分别为31眼、26眼,分别占96.88％和81.25％.所有患者术中前房稳定,均无切口部位的热损伤.结论 1.8mm同轴微切口白内障超声乳化摘出术安全、有效,并可通过1.8mm的切口植入IOL,术后疗效良好.
배경 수착초성유화백내장적출술적발전화진보,탐색재경소절구하안전、유효지적출혼탁정상체적수술방식,종이감경술중조직적손상정도,감소술후병발증적발생솔축점성위림상관주적초점. 목적 탐토1.8mm동축미절구초성유화백내장적출술적가행성화림상료효. 방법 본연구위계렬병례관찰연구.납입2012년4-5월재내몽고자치구인민의원안과의행초성유화백내장적출술적단순년령상관성백내장환자32례32안,기중Ⅱ급핵자8례8안,Ⅲ급핵자16례16안,Ⅳ급핵자8례8안.소유환안행A형초성측량안축장도,IOL도수안조SRK-Ⅱ공식계산.대환안행염산병미잡인적안액표면마취,우10:00 ～11:00위용전용수술도행1.8mm수도식투명각막절구,우2:00위주측절구,기타보취동상규초성유화백내장적출술,병통과1.8mm적절구식입Akreos MI60형인공정상체(IOL).관찰술중초성유화시간、술후시력화수술병발증.결과 소유술안수술순리.각급핵환안술중평균초성유화유효시간위(7.0±3.6)s,평균초성능량위(15.3±6.1)％.술후1d、1주급1개월시라안시력≥0.5적술안분별위18、28화30안,분별점56.25％、87.50％급93.75％;술후1개월최가교정시력≥0.5화0.8자분별위31안、26안,분별점96.88％화81.25％.소유환자술중전방은정,균무절구부위적열손상.결론 1.8mm동축미절구백내장초성유화적출술안전、유효,병가통과1.8mm적절구식입IOL,술후료효량호.
Background With the development of phacoemulsification surgery,the minimization of the size of the incision in order to reduce the damaging of eye tissue and postoperative complications becomes a focus.Objective This study aimed to assess the clinical efficacy of coaxial phacoemulsification type cataract surgery through a 1.8 mm microincision with foldable intraocular lens (IOL) implantation in eyes with age-related cataract.Methods Informed consent was obtained from each patient at the beginning of this study.A serial case observation study was designed.Thirty-two eyes of 32 patients with age-related cataract were enrolled in the Inner Mongolia Autonomous Region People' s Hospital from April 2012 to May 2012,including 8 eyes of grade Ⅱ hard nucleus cataract,16 eyes of grade Ⅲ hard nucleus cataract and 8 eyes of grade Ⅳ hard nucleus cataract.Ocular axial length was measured by an A-mode ultrasonic apparatus,and IOL diopter was calculated using the SRK-Ⅱ formula.Under ocular surface anesthesia,a 1.8 mm clear corneal tunnel incision was made at the 10-11 o' clock position,and then an auxiliary incision was made at the 2 o' clock position.The opaque lens was extracted by routine phacoemulsification.An Akreos MI60 IOL was implanted through the 1.8 mm incision.The time and level of ultrasonic power required for phacoemulsification,postoperative visual acuity and incidence of postoperative complication were assessed.Postoperative examinations were scheduled at 1 day,1 week and 1 month after the surgery.Results All the operations proceeded smoothly.The mean phaco-time was (7.0±3.6) seconds and the mean ultrasonic power level was (15.3 ±6.1)％ among the different grades of cataract groups.The number of eyes presenting an uncorrected distance visual acuity of ≥ 0.5 was 18 (56.25％),28 (87.50％) and 30 (93.75％) 1 day,1 week and 1 month after surgery,respectively.The number of eyes with a best corrected distance visual acuity of ≥ 0.5 and 0.8 were 31(96.88％) and 26 (81.25％),respectively,1 month after surgery.Negligible changes were detected in the anterior chamber depths,and no thermal damage was found at the incision during the operation.Conclusions Coaxial phacoemulsification and IOL implantation through a 1.8 mm microincision is safe and effective.Thorough planning and precise execution are necessary.